Choosing and Monitoring a Rehabilitation Facility

A patient’s recovery can be delayed or reduced if he or she does not get the right amount or level of rehabilitation, which is why it’s important to choose the right rehabilitation program for them.

One of the most important and complicated decisions to be made by, or for, a patient after suffering catastrophic brain injury is the choice of a rehabilitation facility. Ideally, you would want a rehabilitation program that is well-equipped to provide you or your loved one with the best possible care while giving considerations for your own personal circumstances and condition.

It can be quite daunting knowing how and where to start when it comes to choosing a rehabilitation program. There are various things to consider, such as the quality of services and care provided by the plethora of facilities, but how exactly does one determine which ones are superior and which ones aren’t? Add to that the fact that often, this decision must be made when the patient is already in acute care hospital and does not have the time or ability to gather all the necessary information about the available programs. Typically, a hospital social worker will talk to you or a family member within the first few days after being admitted, and he or she can help you launch the search for a suitable rehabilitation program.

Ask these questions when choosing and evaluating a rehabilitation facility:

1. Know Your Needs

  • How healthy is the patient?
  • How severe is the patient’s condition?
  • How intense must the rehabilitation be?

2. Know Your Financial Situation

  • What kind of health insurance policy does the patient have?
  • Is the patient limited by the health insurance plan when it comes to the amount and type of therapy or other services they can receive?
  • Depending on the cause of injury, is there other compensation available to the patient with legal help?

3. Determine the Required Setting

  • What kind of setting will best suit the needs of the patient?
    • Outpatient
    • Home
    • Nursing home
    • Skilled nursing facility
    • Day rehabilitation
    • Acute rehabilitation
    • Subacute rehabilitation

4. Evaluate the Facility

  • How many patients are admitted to the rehabilitation program every year?
  • What percentage of patients admitted during the past year had the same diagnoses as you or your loved one?
  • Are there patients in the program that are of the same age and gender as you or your loved one?
  • What is the average age of patients in the program?
  • Does the facility specialize in services for acquired brain injury rehabilitation or is it one of many that they offer?
  • In case of life-threatening emergencies, is the facility equipped to handle them?
  • Will patients need to be transferred to a different floor, unit or medical facility if new medical issues come up?
  • Does the facility offer an inpatient program for patients who are comatose or at a minimally-conscious state?
  • How often do patients get treatments by specialists, such as physical therapists or speech therapists? How long do the treatments take each day?
  • Does the facility offer services at different stages of recovery, such as intensive care, inpatient rehabilitation, outpatient care, etc.?
  • Are there weekend and evening activities planned for patients?
  • Does the facility ensure ongoing staff development and training for all personnel?
  • Are they CARF accredited?
  • Are they JCAHO accredited?
  • Are staff members helpful and approachable? Are they able to satisfactorily answer your questions?
  • Will you be given the opportunity to tour the facility?
  • Can you speak with people who are participating in the program, or their families? How satisfied are they with their rehabilitation program and the care they receive?
  • What are your overall impressions with the facility and its personnel?

5. Evaluate the Outcomes

  • What is the average length of stay for patients with injuries that are similar to yours or your loved one’s?
  • When past patients were discharged, where were they discharged to? (home, nursing home or assisted living; home is most ideal)
  • What are the Functional Independence Measure (FIM) scores achieved by brain injury patients from the time of admission to their discharge?

6. Determine the Availability of Counseling Services

  • Does the facility provide coping and support services? What types are available?
    • Individual therapy
    • Group therapy
    • Peer support
    • Family counseling
    • Substance abuse counseling
    • Psychotherapy
    • Neuropsychology

7. Determine Support for Families

  • Does the facility encourage the family’s participation in the patient’s rehabilitation?
  • How and to what extent?
  • Does the facility offer programs to educate family members on caregiving responsibilities in preparation for the patient’s discharge?
  • Does the facility offer support for the family after the patient is discharged? What type of support is available?

Remember that it’s important to take as much time as possible to consider various rehabilitation facilities and programs so you will be able to make an informed decision. Gather all the necessary information about each program, its staff and track record. If there is anything about the program that you don’t comprehend, don’t hesitate to ask questions and make sure that it is explained in such a way that you completely understand.

Some facilities may not be included on the list of facilities covered by your insurance plan; don’t rule them out straight away. You never know if the insurance company will be able to make exceptions and it won’t hurt to try. Additionally, don’t dismiss a facility right away based on its location, especially if it seems to be the best program for your loved one. Many rehabilitation programs offer temporary housing or other living options for families who must travel long distances.

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