Inpatient rehab candidacy

[thiswonthurtabit]

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[lobelsteve]

Do you like food? Having a job? Do you want to graduate residency?

Inpatient criteria as resident: has heartbeat.

 

[RUOkie]

Quick question about admitting patients to inpatient rehabilitation: Is it kosher to admit patients to inpatient rehabilitation with goals and plan for discharge home in your admission documentation even if you know the patient will be going to a SNF when discharged from rehab?

I've had a few occurrences where my attending has told me to change my documentation to bring someone to our unit when we've known they were destined for a skilled facility. For example a patient would not be able to discharge to home safely without assistance and they had no one to provide such assistance but we brought them to our unit anyway with goals that they really had no chance of achieving and discharged them to a skilled facility 8 days later. I know that the attending is running the show and I have to do what they tell me but this kind of thing makes me feel very uncomfortable and possibly fraudulent.

This right here is why I divorced myself from all inpatient rehab 5 yrs ago.

 

[thiswonthurtabit]

Do you like food? Having a job? Do you want to graduate residency?

Inpatient criteria as resident: has heartbeat.

Absolutely. However my concern is that our unit is currently being reviewed by several insurances for inconsistencies and I want to know if things like this are going to worsen the situation. If we lose our contracts with these insurances we may not be able to fill enough beds for residency requirements. Kinda screwed either way you slice it.

 

[lobelsteve]

If you are a resident yoir job is to learn what to do and what not to do. Do not rock the boat just keep your eyes open and your mouth shut. This will soon pass. It will take longer for shutting down the program and it'll take for you to graduate. And even if the program got shut down you would be absorbed by another program.

 

[melancholy]

maybe there is some political pressure from the other ward teams to dispo the patient to your rehab unit or there is some drive to keep the beds full? "everyone may benefit from acute rehab, BUT....." is the key.

 

[Taus]

Pulse? Check

Insurance will pay? Check

Admitted.


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[buddy 2004]

You should try to focus on the small gains and not just the end point of independent living. Having a patient do most self care and transfers with supervision or CG assist is a big deal compared to assist of two no matter where they end up.

 

[Paddington]

I'm not doing inpatient but I think most debilitated patients do benefit from the inpatient rehab and some of these very sick patients if they just went straight to the SNF they will lie mostly in neglect, whereas if they even get those few days of intensive rehab it sets them up much better for the future, even if they don't have a direct discharge back to home.