Skip to main content

Acute Rehabilitation Care

  • Chapter
  • First Online:
Chronic Illness Care
  • 2827 Accesses

Abstract

Rehabilitation is a multidisciplinary approach to helping patients overcome disability and reach their highest possible degree of performance after an acute medical event or surgical procedure. Effective rehabilitation involves a multidisciplinary team of health-care professionals who work together in complimentary fashion and communicate regularly. Comprehensive rehabilitation involves selecting the right setting that takes into account the care needs of the patient, cognitive status, and support systems. Rehabilitation can be offered through inpatient or outpatient services. Inpatient services include hospital rehabilitation units, long-term care hospitals, and skilled nursing facilities. Outpatient rehabilitation is conducted at home or in an ambulatory care setting. For Medicare to cover rehabilitation services, the patient must have a hospital stay of at least 3 consecutive days for a related illness or injury, known as a “qualifying stay.” Durable medical equipment plays an important role in rehabilitation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Boston Working Group on improving health care outcomes through geriatric rehabilitation. Med Care. 1997;35(6 Suppl):Js4–20.

    Google Scholar 

  2. Halstead LS. Team care in chronic illness: a critical review of the literature of the past 25 years. Arch Phys Med Rehabil. 1976;57(11):507–11.

    CAS  PubMed  Google Scholar 

  3. JA DL, Gans BM, editors. Physical medicine and rehabilitation : principles and practice. Philadelphia: Lippincott Williams & Wilkins; 2005.

    Google Scholar 

  4. Batmangelich S, Cristian A. Physical medicine and rehabilitation patient-centered care : mastering the competencies. New York: Demos Medical; 2015.

    Google Scholar 

  5. U.S. Centers for Medicare & Medicaid Services. IRF PPS and the 75% rule [document on the internet]. Baltimore: The Department of Health and Human Services; 2007 [cited 2017 Jan 4]. Available from: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/InpatientRehabFacPPS/downloads/IRF_PPS_75_percent_rule_060807.pdf.

  6. Liu K, Baseggio C, Wissoker D, Maxwell S, Haley J, Long S. Long-term care hospitals under medicare: facility-level characteristics. Health Care Financ Rev. 2001;23(2):1–18.

    PubMed  PubMed Central  Google Scholar 

  7. U.S. Centers for Medicare & Medicaid Services. Statement of work long term care hospital payment system refinement/evaluation. Available from: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/downloads/sow_ltch.pdf. Accessed 11 Dec 2016.

  8. U.S. Centers for Medicare & Medicaid Services. Long-term care hospital PPS: centers for medicare and medicaid services; 2013 [updated 04/16/2013 3:07 PM 04/16/2013 3:07 PM]. Available from: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/index.html. Accessed 11 Jan 2017.

  9. U.S. Centers for Medicare & Medicaid Services. Chapter 8 – Coverage of extended care (SNF) services under hospital insurance. In: Medicare benefit policy manual [document on the Internet]. Baltimore: The Department of Health and Human Services; 2014 [cited 2017 Jan 4]. Available from: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c08.pdf.

  10. U.S. Centers for Medicare & Medicaid Services. Medicare coverage of skilled nursing facility care. In: Medicare benefit policy manual [document on the Internet]. Baltimore: The Department of Health and Human Services; 2015 [cited 2017 Jan 4]. Available from: https://www.medicare.gov/pubs/pdf/10153.pdf.

  11. Federal Nursing Home Reform Act from the Omnibus Budget Reconciliation Act of 1987.

    Google Scholar 

  12. U.S. Centers for Medicare & Medicaid Services. Chapter 7 – Home health services. In: Medicare benefit policy manual [document on the Internet]. Baltimore: The Department of Health and Human Services; 2015 [cited 2017 Jan 4]. Available from: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c07.pdf.

  13. U.S. Centers for Medicare & Medicaid Services. Chapter 15 – Covered medical and other health services. In: Medicare benefit policy manual [document on the Internet]. Baltimore: The Department of Health and Human Services; 2016 [cited 2017 Jan 4]. Available from: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c15.pdf.

  14. Kabboord AD, van Eijk M, Fiocco M, van Balen R, Achterberg WP. Assessment of comorbidity burden and its association with functional rehabilitation outcome after stroke or hip fracture: a systematic review and meta-analysis. J Am Med Dir Assoc. 2016;17:1066.

    Article  PubMed  Google Scholar 

  15. Wells JL, Seabrook JA, Stolee P, Borrie MJ, Knoefel F. State of the art in geriatric rehabilitation. Part I: review of frailty and comprehensive geriatric assessment. Arch Phys Med Rehabil. 2003;84(6):890–7.

    Article  PubMed  Google Scholar 

  16. U.S. Centers for Medicare & Medicaid Services. Quality measures 2016 [updated 04/28/2016 9:40 AM]. Available from: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments/NursingHomeQualityInits/NHQIQualityMeasures.html. Accessed 4 Jan 2017.

  17. White paper on the nursing home medical director: leader and manager 2011. Available from: http://www.paltc.org/amda-white-papers-and-resolution-position-statements/nursing-home-medical-director-leader-manager. Accessed 4 Jan 2017.

  18. Underlying Cause of Death 1999–2013 on CDC WONDER Online Database, released 2015. [Data are from the Multiple Cause of Death Files, 1999–2013, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program: http://wonder.cdc.gov/ucd-icd10.html]. In press.

  19. Mozzafarian D Benjamin E, Go AS, et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2016 update: a report from the American Heart Association. Circulation. 2016;133:e38.

    Google Scholar 

  20. Musicco M, Emberti L, Nappi G, Caltagirone C. Early and long-term outcome of rehabilitation in stroke patients: the role of patient characteristics, time of initiation, and duration of interventions. Arch Phys Med Rehabil. 2003;84(4):551–8.

    Article  PubMed  Google Scholar 

  21. Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2016;47(6):e98–e169.

    Article  PubMed  Google Scholar 

  22. Management of Stroke Rehabilitation Working Group, Bates B, Glasberg J, Hughes K, Katz R, Priefer B, Richards L, Ruff R, Sullivan P, Zartman AL, Cassidy C, Lux L, Viswanathan M, Lohr K, Bowles A, Crumpton S, Lambert K, Alexander DN, Duncan PW, Lutz B, Degenhardt E, Klar AV, D’Erasmo M, Fishman R. VA/DOD Clinical practice guideline for the management of stroke rehabilitation. J Rehabil Res Dev. 2010;47(9):1–43.

    Google Scholar 

  23. Kalra L, Yu G, Wilson K, Roots P. Medical complications during stroke rehabilitation. Stroke. 1995;26(6):990–4.

    Article  CAS  PubMed  Google Scholar 

  24. Brandstater ME. Stroke rehabilitation. In: Delisa JA, editor. Physical medicine and rehabilitation: principles and practice. 2. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2005. p. 1655–76.

    Google Scholar 

  25. Brandstater ME, Roth EJ, Siebens HC. Venous thromboembolism in stroke: literature review and implications for clinical practice. Arch Phys Med Rehabil. 1992;73(5-s):S379–91.

    CAS  PubMed  Google Scholar 

  26. Ayerbe L, Ayis S, Wolfe CD, Rudd AG. Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry J Ment Sci. 2013;202(1):14–21.

    Article  Google Scholar 

  27. Watkins C, Daniels L, Jack C, Dickinson H, van Den Broek M. Accuracy of a single question in screening for depression in a cohort of patients after stroke: comparative study. BMJ (Clin Rese Ed). 2001;323(7322):1159.

    Article  CAS  Google Scholar 

  28. Chemerinski E, Robinson RG, Kosier JT. Improved recovery in activities of daily living associated with remission of poststroke depression. Stroke; J Cereb Circ. 2001;32(1):113–7.

    Article  CAS  Google Scholar 

  29. Hip Fractures Among Older Adults. [Available from: HCUPnet. Healthcare Cost and Utilization Project (HCUP). 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://hcupnet.ahrq.gov. Accessed 5 Aug 2016.

  30. Cree M, Carriere KC, Soskolne CL, Suarez-Almazor M. Functional dependence after hip fracture. Am J Phys Med Rehabil/Assoc Acad Physiatrists. 2001;80(10):736–43.

    Article  CAS  Google Scholar 

  31. Abou-Setta AM, Beaupre LA, Jones CA, Rashiq S, Hamm MP, Sadowski CA, et al. AHRQ comparative effectiveness reviews. Pain management interventions for hip fracture. Rockville: Agency for Healthcare Research and Quality (US); 2011.

    Google Scholar 

  32. Roche JJW, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ Br Med J. 2005;331(7529):1374.

    Article  CAS  Google Scholar 

  33. Koval KJ, Zuckerman JD. Functional recovery after fracture of the hip. J Bone Joint Surg Am. 1994;76(5):751–8.

    Article  CAS  PubMed  Google Scholar 

  34. Bernardini B, Meinecke C, Pagani M, Grillo A, Fabbrini S, Zaccarini C, et al. Comorbidity and adverse clinical events in the rehabilitation of older adults after hip fracture. J Am Geriatr Soc. 1995;43(8):894–8.

    Article  CAS  PubMed  Google Scholar 

  35. Guccione AA, Fagerson TL, Anderson JJ. Regaining functional independence in the acute care setting following hip fracture. Phys Ther. 1996;76(8):818–26.

    Article  CAS  PubMed  Google Scholar 

  36. White BLB. Rate of mortality for elderly patients after fracture of the hip in the 1980s. J Bone Joint Surg Am Vol. 69(9):1335–40.

    Google Scholar 

  37. Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e278S–325S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Morrison RS, Magaziner J, McLaughlin MA, Orosz G, Silberzweig SB, Koval KJ, et al. The impact of post-operative pain on outcomes following hip fracture. Pain. 2003;103(3):303–11.

    Article  PubMed  Google Scholar 

  39. Cleeland CS. Undertreatment of cancer pain in elderly patients. JAMA. 1998;279(23):1914–5.

    Article  CAS  PubMed  Google Scholar 

  40. Ferrell BA. Pain management in elderly people. J Am Geriatr Soc. 1991;39(1):64–73.

    Article  CAS  PubMed  Google Scholar 

  41. The management of chronic pain in older persons. AGS Panel on Chronic Pain in Older Persons. American Geriatrics Society. Geriatrics. 1998;53(Suppl 3):S8–24.

    Google Scholar 

  42. Abou-Setta AM BL, Jones CA, et al. Pain management interventions for hip fracture. Comparative effectiveness review No. 30. (Prepared by the University of Alberta Evidence-based Practice Center under Contract No. 290–02-0023.). AHRQ Publication No 11-EHC022-EF. 2011;Rockville: Agency for Healthcare Research and Quality.

    Google Scholar 

  43. Wilson MG, Michet CJ Jr, Ilstrup DM, Melton LJ 3rd. Idiopathic symptomatic osteoarthritis of the hip and knee: a population-based incidence study. Mayo Clin Proc. 1990;65(9):1214–21.

    Article  CAS  PubMed  Google Scholar 

  44. Nicholas JJ, Aliga N. Rehabilitation following arthroplasty. Physical medicine and rehabilitation: the complete approach: Blackwell Science; 2000. p. 1551–64.

    Google Scholar 

  45. HCPUnet, Healthcare Cost and Utilization Project: Agency for Healthcare Research and Quality; [12/20/12]. Available from: http://hcupnet.ahrq.gov. Accessed 15 Dec 2016.

  46. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780–5.

    PubMed  Google Scholar 

  47. Stulberg VABaSD. Rehabilitation after lower limb joint reconstruction. In: JA DL, editor. Physical medicine and rehabilitation: principles and practice, vol. 1. Philadelphia: Lippincott Williams and Wilkins; 2005. p. 855–72.

    Google Scholar 

  48. Krotenberg R, Stitik T, Johnston MV. Incidence of dislocation following hip arthroplasty for patients in the rehabilitation setting. Am J Phys Med Rehabil/Assoc Acad Physiatrists. 1995;74(6):444–7.

    Article  CAS  Google Scholar 

  49. Buvanendran A, Kroin JS, Tuman KJ, Lubenow TR, Elmofty D, Moric M, et al. Effects of perioperative administration of a selective cyclooxygenase 2 inhibitor on pain management and recovery of function after knee replacement: a randomized controlled trial. JAMA. 2003;290(18):2411–8.

    Article  CAS  PubMed  Google Scholar 

  50. Jacobs JJ, Mont MA, Bozic KJ, Della Valle CJ, Goodman SB, Lewis CG, et al. American academy of orthopaedic surgeons clinical practice guideline on: preventing venous thromboembolic disease in patients undergoing elective hip and knee arthroplasty. J Bone Joint Surg Am. 2012;94(8):746–7.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, et al. Antithrombotic therapy for vte disease: chest guideline and expert panel report. Chest. 2016;149(2):315–52.

    Article  PubMed  Google Scholar 

  52. Shah SS, Satin AM, Mullen JR, Merwin S, Goldin M, Sgaglione NA. Impact of recent guideline changes on aspirin prescribing after knee arthroplasty. J Orthop Surg Res. 2016;11(1):123.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Stewart DW, Freshour JE. Aspirin for the prophylaxis of venous thromboembolic events in orthopedic surgery patients: a comparison of the AAOS and ACCP guidelines with review of the evidence. Ann Pharmacother. 2013;47(1):63–74.

    Article  PubMed  Google Scholar 

  54. An VV, Phan K, Levy YD, Bruce WJ. Aspirin as thromboprophylaxis in hip and knee arthroplasty: a systematic review and meta-analysis. J Arthroplast. 2016;31(11):2608–16.

    Article  Google Scholar 

  55. Kaye HS, Kang T, LaPlante MP. Mobility device use in the united states. Washington, D.C: National Institute on Disability and Rehabilitation Research, US Department of Education; 2000.

    Google Scholar 

  56. Foley KTB, Cynthia J. Rehabilitation. In: Durso SC, Sullivan GM, editors. Geriatrics review syllabus: a core curriculum in geriatric medicine. 8th ed. New York: American Geriatric Society; 2013.

    Google Scholar 

  57. U.S. Centers for Medicare & Medicaid Services. Chapter 20 Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). In: Medicare benefit policy manual [document on the Internet]. Baltimore: The Department of Health and Human Services; 2016 [cited 2017 Jan 4]. Available from: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c20.pdf.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karen D. Halpert .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Halpert, K.D. (2018). Acute Rehabilitation Care. In: Daaleman, T., Helton, M. (eds) Chronic Illness Care. Springer, Cham. https://doi.org/10.1007/978-3-319-71812-5_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-71812-5_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-71811-8

  • Online ISBN: 978-3-319-71812-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics