Choosing a Rehabilitation Program

A summary of "Choosing a High-Quality Medical Rehabilitation Program: An NRH Field Guide for People with Disabilities"

Many people live with disabilities that limit them from being able to fully function. For many, a rehabilitation program will help them to gain increased functionality and more freedom. Follow these steps to choose a rehabilitation program that best suits you.

Step 1: Determine your current rehabilitation needs
The type of care an individual seeks is based on their functional ability to perform everyday tasks. An individual may need to ask the question, “How healthy am I?” Usually an individual will receive medical care to stabilize their condition before seeking rehabilitation.

Step 2: Determine what type of health coverage your insurance has

Types of health insurance:

• Traditional health insurance, or fee-for-service plans, pay for a fraction of the annual health care needs after the deductible is paid. There are more options for rehabilitation through traditional health insurance plans.
• Managed care plans set up services at a reduced price to those who agree to only get medical care from approved physicians at specific practices. Primary care doctors will refer individuals under this plan to a rehabilitation program.

Ways to pay for health insurance:

• Private payers are usually employers who cover the health services of their employees. Individuals can also purchase their own private health insurance plans without an employer.
• Public payers are the government-run programs. Medicare and Medicaid are public payer programs.

Step 3: Choose a rehabilitation program:
There are many types of rehabilitation programs to choose from. After an individual determines how healthy they are, what type of care they need, and what type of medical coverage they receive from their insurance plan they can proceed to choosing the appropriate rehabilitation program for them.

Types of rehabilitation programs:

• Acute rehabilitation provides medical and a full range of rehabilitation services including: physical therapy, occupational therapy, rehabilitation nursing, speech-language therapy, vocational rehabilitation, and therapeutic recreation. A personalized interdisciplinary program is created for each individual by a medical team and provided at an acute rehabilitation facility where they receive 24-hour care.
• Subacute rehabilitation is provided after an individual completes an acute rehabilitation program. These services are provided at a subacute rehabilitation facility or at a skilled nursing unit. The patient still is under 24-hour care.
• Home health care are services where the healthcare professionals travel to the patient’s home to provide rehabilitation between one to seven days a week. This usually covers physical therapy, occupational therapy, and speech-language therapy only.
• Day rehabilitation is much like acute rehabilitation where the patient does not have to stay overnight at the rehab facility.
• Outpatient rehabilitation is available to individuals who are able to travel to the outpatient facility and do not need around-the-clock care. Patients will receive only one or two services and no additional nursing care.
• Nursing home rehabilitation is when the patient receives care at the nursing home where they reside. Services offered vary from one nursing home to another.

When choosing a rehabilitation program find one where the healthcare professionals of the rehabilitation team are qualified to treat patients. These professionals should have rehabilitation training and experience in their fields. It is a good idea to research the rehabilitation program’s Functional Independence Measure (FIM). FIM is administered to patients when they are admitted to the program and again when they are discharged. An individual’s FIM score can range from 18 to 126. A higher score represents a more independent patient.

This is a summary of the guidebook, “Choosing a High-Quality Medical Rehabilitation Program: An NRH Field Guide For People With Disabilities” published by the National Rehabilitation Hospital (NRH) and printed here with permission from the NRH. NRH specializes in treating persons with physical disabilities caused by spinal cord and head injuries, stroke, arthritis, amputation, multiple sclerosis, post-polio syndrome, and other neurological and orthopedic conditions. To download a PDF version of this unabridged guidebook, go to www.nrhrehab.org/documents/research/choosing.pdf.

About the author:

The National Rehabilitation Hospital (NRH) specilizes in treating persons with physical disabilities caused by spinal cord and head injuries, stroke, arthritis, amputation, multiple sclerosis, post-polio syndrome, and other neurological and orthopedic conditions. It has grown from a single hospital to the NRH Medical Rehabilitation Network providing inpatient and outpatient care and day treatment programs.