What are the discharge criteria for an adult or elderly patient with a history of stroke or cerebrovascular conditions based on the York Rehabilitation and Mobility Score (YRMS) scoring criteria?

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YRMS Scoring Criteria for Discharge

I cannot provide specific York Rehabilitation and Mobility Score (YRMS) discharge criteria because none of the provided evidence contains information about YRMS or its scoring system. The evidence focuses on other assessment tools and discharge planning considerations for stroke patients, but does not address YRMS specifically.

What the Evidence Does Provide

Functional Assessment Tools for Discharge Planning

Alternative validated tools are available for discharge decision-making in stroke rehabilitation:

  • Activity Measure for Post-Acute Care "6-Clicks" demonstrates good predictive ability for discharge destination, with Basic Mobility cut-point of ≤40.78 (raw score 16) and Daily Activity cut-point of ≤40.22 (raw score 19) predicting institutional versus community discharge 1

  • Section GG mobility and self-care scores can guide discharge decisions, with admission cut-off score of 33.5 distinguishing home with homecare versus skilled nursing facility, and 36.5 for home with outpatient care versus skilled nursing facility 2

  • Functional Independence Measure (FIM) at admission, particularly motor scores, predicts discharge to acute care versus community in severely affected stroke patients 3

Evidence-Based Discharge Criteria from Guidelines

The American Heart Association/American Stroke Association recommends the following discharge assessment framework 4:

  • All stroke patients discharged to independent community living must receive ADL and IADL assessment directly related to their discharge living setting (Class I recommendation) 4

  • Formal follow-up assessment of mobility, ADL, and communication/cognition should occur within 30 days after discharge home from acute hospital or postacute facility (Class IIa recommendation) 4

  • Discharge planning should establish a safe and enabling home environment and confirm caregivers have adequate support before discharge 4

Key Predictors of Discharge Destination

Presence of a home caregiver is consistently the strongest predictor of discharge destination (P<0.001), followed by functional mobility and self-care scores as secondary factors 2

  • Patients unable to perform the 10-Meter Walk Test at discharge, combined with rehabilitation length of stay and balance scores <4, predict institutional discharge with 86.4% accuracy 5

  • Admission motor function is the primary predictor of discharge to acute care from inpatient rehabilitation in severely affected stroke patients 3

Clinical Recommendation

Without YRMS-specific criteria in the available evidence, discharge decisions for stroke patients should utilize validated functional assessment tools (6-Clicks, Section GG, or FIM) combined with evaluation of caregiver availability, home safety, and achievement of rehabilitation goals 4, 1, 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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