How can I determine where my loved one or I should receive physical rehabilitation? What are outcomes and why are they so important in a post-acute care setting?
You may find yourself asking these questions if you are looking for a post-acute care facility for yourself or a loved one. It is important to make an informed choice when determining where a patient will receive physical rehabilitation. Outcome data may be helpful to you if you must make that decision.
Post-acute care is comprised of inpatient and outpatient settings. Inpatient settings typically consist of a long term acute hospital level of care, an inpatient acute physical rehabilitation level of care or a skilled nursing level of care.
Helen Hayes Hospital has two inpatient post-acute levels of care. The first is an inpatient physical rehabilitation level of care that is mandated by Medicare to meet certain criteria, including the provision of three hours of therapy per day, as well as the availability of a physician 24 hours per day. The Helen Hayes Hospital Skilled Nursing Facility is the other post-acute level of care and is required by Medicare to provide a skilled level of care to all patients. Medicare has other requirements for these levels of care, as well as for other levels of care, also.
So, where do outcomes come into play? As a skilled nursing facility (SNF) or an inpatient rehab facility (IRF) the Centers for Medicare & Medicaid Services (CMS) publishes outcome data on Nursing Home Compare for SNFs, as well as Hospital Compare for IRFs. These outcomes can be found on the internet at www.medicare.gov/nursinghomecompare or Hospital Compare. These websites can initially guide a healthcare consumer in making an informed decision regarding choosing a post-acute care facility based upon such outcomes as quality concerns or accreditations.
If an IRF level of care is appropriate, outcomes are often reported on the IRF website or may be discussed during an IRF visit. Top facilities often seek accreditation, meeting a higher set of standards.
As required by the accrediting agency, CARF (Commission on Accreditation of Rehabilitation Facilities), Helen Hayes Hospital and other accredited IRFs must provide all persons served with outcome data. Many inpatient rehab facilities, including Helen Hayes Hospital, meet this standard by posting their outcome data on their hospital website. These outcomes can be quite informative, especially when the data posted is relevant. While an average length of stay is important to know, and it may be interesting to see how many patients are male or female, it is probably more important to know what number of patients are discharged to a community setting- home- as this outcome is more indicative of the gains a patient may make while in rehab. Of course, sometimes a short term stay in a nursing home helps bridge the gap between rehabilitation and home but it is important to remember that the ultimate goal of discharge home is important in a nursing home setting as well, since many nursing facilities do become home for some of their patients. A goal of rehab for most patients is to assist the person served in reaching their highest level of independence with discharge to the least restrictive environment possible.
Take a look at the outcomes on the Helen Hayes Hospital website, as well as other facilities. We think answering the question where you should receive rehab will become much clearer…
-Joann Dittmer, RN
Director of Quality Assurance and Outcome Management