From the Guidelines
Inpatient Rehabilitation Facilities (IRFs) are indicated for patients who require intensive, multidisciplinary rehabilitation services under physician supervision, with the ability to participate in at least 3 hours of therapy per day, 5 days a week, and demonstrate the potential for significant functional improvement, as supported by the most recent guidelines from the American Heart Association 1. The indications for IRF admission include:
- Stroke with moderate to severe deficits
- Spinal cord injury
- Traumatic brain injury
- Major multiple trauma
- Hip fracture with multiple comorbidities
- Certain neurological disorders, such as Parkinson's disease or multiple sclerosis
- Burns
- Major joint replacements with complications or multiple comorbidities Patients must require active and ongoing intervention from multiple therapy disciplines, including physical therapy, occupational therapy, and speech-language pathology, as well as close medical supervision and an intensive rehabilitation nursing component 1. The decision to admit a patient to an IRF should be based on a comprehensive preadmission assessment, documenting the medical necessity and rehabilitation potential, with continued stay dependent on documented progress toward rehabilitation goals 1. It is essential to note that IRF admission requires a multidisciplinary team approach, with frequent, direct, and medically necessary physician involvement in the patient's care, as well as evidence of a coordinated program through team conferences and documentation of the patient's progress or problems impeding progress 1.
From the Research
Indications for Inpatient Rehabilitation Facilities (IRF)
- The primary indication for IRF is the need for intensive rehabilitation services, such as physical, occupational, and speech therapy, to improve functional abilities and achieve optimal recovery 2, 3.
- IRF care is often required for individuals with significant impairments or disabilities, such as those resulting from stroke, spinal cord injury, traumatic brain injury, or other neurological conditions 4, 5.
- The decision to admit a patient to an IRF is typically based on the patient's medical stability, functional abilities, and potential for rehabilitation, as well as the availability of appropriate resources and services 2, 3.
- Common conditions that may require IRF care include:
- The goal of IRF care is to provide a comprehensive and interdisciplinary approach to rehabilitation, with the aim of maximizing functional independence, reducing disability, and improving overall quality of life 2, 4.