Admission Criteria for Inpatient Rehabilitation

admission criteriaInpatient rehabilitation is the highest, most intense level of post-acute care for rehabilitation. But when is a stay in an acute rehabilitation hospital the appropriate level of care? Who decides?

Often, it is the Centers for Medicare/Medicaid Services (CMS) or other private insurance companies that dictate the level of care. They provide admission criteria for inpatient rehabilitation facilities, like Good Shepherd Rehabilitation Hospital, to follow.

Under CMS guidelines, inpatient admission to a rehabilitation hospital must be “reasonable and necessary.” The potential patient must:

  • Require multiple therapy disciplines, such as physical therapy, occupational therapy and/or speech therapy
  • Require a daily intensive rehabilitation program (3 or more hours, 5 days a week)
  • Be able to actively participate in the program
  • Require the supervision of a physician who specializes in physical medicine and rehabilitation
  • Be expected to make measurable improvement

According to Medicare policy, admission to an inpatient rehabilitation hospital is appropriate for patients who have complex nursing, medical management and rehabilitation needs. These patients can benefit the most from:

Intensive Rehabilitation

  • Therapy 7 days a week, 3 or more hours for 5 days
  • Individualized therapy plans

Specialized Staff and Resources

  • An expert team of clinicians, including physicians, therapists and nurses, who have specialized training and/or certifications in the rehabilitation of orthopedic injuries, stroke, brain injury and spinal cord injury
  • Additional staff on duty to meet patient needs, including internal medicine physicians
  • Rehabilitation technology and equipment, including state-of-the-art telemedicine (real-time, interactive communication between the patient and off-site physicians and clinicians)

For more information regarding inpatient admissions, call 1-888-44-REHAB or contact us.

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