For Patients

Talking Points

Key Study Findings

  • This study shows that patients treated in inpatient rehabilitation hospitals and units have better outcomes, go home earlier and live longer than patients treated in nursing homes.
  • Patients treated in inpatient rehabilitation hospitals and units achieve better clinical outcomes in a shorter time and use less facility-based care than those treated in nursing homes.
  • Patients treated in skilled nursing facilities have more emergency room visits, are readmitted to hospitals more often, and have an increased risk of death than clinically similar patients treated in inpatient rehabilitation hospitals and units.

Policy Implications

  • The study makes clear that nursing homes and inpatient rehabilitation hospitals and units are not the same and should not be treated as such by Members of Congress or Medicare.
  • Members of Congress and the Centers for Medicare and Medicaid Services (CMS) should ensure that Medicare beneficiaries receive the right treatment in the right setting, not be forced into the setting that is the least expensive in the short-term.
  • Congress should avoid policies that divert patients out of inpatient rehabilitation hospitals and units and into nursing homes, which would deny many Medicare patients the care they need to more quickly return to their family and community activities.
  • If Congress is going to advance policy proposals that do not account for the differences in care provided in inpatient rehabilitation hospitals and nursing homes, but rather consider them as the same, then nursing homes should be held to the same rehabilitation standards as inpatient rehabilitation hospitals and units.
  • There are virtually no minimum requirements applicable to nursing homes that relate to the rehabilitation care they must provide to patients, let alone assessments to track patient progress and improvements in functional outcomes.
  • Forcing patients into less intensive, less capable care settings is not a responsible approach to health policy for Medicare beneficiaries in need of rehabilitation services.

Inpatient Hospital-Level Medical Rehabilitation Saves Lives

  • Inpatient medical rehabilitation is a unique level of care – a highly specialized, carefully coordinated, intensive, and individualized program that improves a patient’s health, function, mobility and independence.
  • Inpatient rehabilitation hospitals and units provide treatment that addresses the full range of medical, physical, cognitive, behavioral, social and vocational issues an individual may face as the result of conditions such as stroke, brain and spinal cord injury, neurological diseases, traumatic injuries, burns and other conditions.
  • The hallmark of inpatient rehabilitation hospitals and units is a highly integrated team approach to treatment. The rehabilitation team is led by a physiatrist, a board certified physician who specializes in physical medicine and rehabilitation (PM&R), and includes rehabilitation nurses, physical therapists, occupational therapists, speech language pathologists, psychologists and neuropsychologists, cognitive therapists, social workers/case managers and dietitians, as well as prosthetists, orthotists, recreational therapists and other clinicians.
  • By tailoring treatment to an individual’s needs and rehabilitation goals, the inpatient rehabilitation hospital teams optimize the abilities, independence and quality of life of each patient.

Dobson | DaVanzo Methodology

  • This study is the most comprehensive national study to date examining the long-term patient outcomes of clinically similar patients treated in inpatient rehabilitation hospitals and units and skilled nursing facilities.
  • The sample is comprised of more than 100,000 matched pairs of clinically similar patients in skilled nursing facilities and inpatient medical rehabilitation hospitals and units. Medicare data were analyzed for a two-year period after illness or injury.
  • The study was conducted by Dobson DaVanzo & Associates, LLC