• IRF or SNF: Which is Best for Your Patient?
      March 14, 2013

      Inpatient Rehabilitation Hospitals (IRFs) and Skilled Nursing Facilities (SNFs) both provide beneficial care to patients, but determining which option is best for your patients can be a challenge. On the surface, there are some similarities between patient populations cared for in both types of facilities, but recent research has shown that certain patients benefit from referral to an IRF over a SNF. Despite efforts to publicize this research, patients may still be directed to the wrong place. Kindred, which operates both skilled nursing facilities and inpatient rehabilitation facilities, can help you decide when and if an IRF is best for your patient.

      IRFs, which are licensed as rehabilitation hospitals and carry the same Medicare certification, have been shown to often be the best option for patients who:

      • Would benefit from more intense physician involvement, including consultation with specialists
      • Can tolerate and benefit from at least three hours of therapy per day
      • Can follow instructions
      • Have the potential to learn how to care for themselves or who have an engaged caregiver who is willing and able to act in that role
      • Have moderate to severe disability
      • Would benefit from round-the-clock skilled nursing
      • May have co-morbidities such as diabetes, hypertension or congestive heart failure (Harvey, 2010)

      Discharge to SNFs, licensed and certified as skilled nursing facilities, may be more appropriate for patients who:

      • Have severe cognitive disability or dementia
      • Can only tolerate 1-2 hours of therapy per day
      • Are unable to learn to care for themselves and lack a suitable caregiver (Harvey, 2010)

      Determining which setting is best for your patients at hospital discharge is critical to their outcomes in the post-acute continuum. When Medicare compared patients with similar profiles, it found that those who went to IRFs had higher functional status at discharge, were walking independently with more frequency at discharge and were transferring independently at discharge, compared to their SNF counterparts. All patients in the study had spent more than 14 days at the facility. (Maintaining Quality Rehabilitation Options for Medicare Beneficiaries, 2007) Kindred can help you evaluate whether your patients have that higher functionality potential.

      If you feel your patient meets IRF criteria, or if you are unsure, we encourage you to speak to one of our case managers to help you determine the right route of transfer.

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