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For referring providers - admission criteria

  • Guidelines for admission to the inpatient rehabilitation units at Courage Kenny Rehabilitation Institute

    Requirements for admission

    • Patient must be medically stable.
    • Patient must demonstrate readiness for rehabilitation.
    • Services must be reasonable and necessary.

    For definitions and guidelines, see admission criteria.

    CMS-13 rehabilitation diagnoses

    • stroke
    • brain injury (traumatic and non-traumatic)
    • neurological disorders (e.g., MS, ALS, etc.)
    • fracture of femur (hip fracture)
    • replacement of lower extremity joint (only if bilateral, obese> 50% BMI, or >85 years old)
    • spinal cord injury (traumatic and non-traumatic)
    • amputation (lower extremity and non-lower extremity)
    • osteoarthritis - severe or advanced, involving two or more major weight-bearing joints with joint deformity, substantial loss of range of motion and atrophy of musclessurrounding the joint
    • rheumatoid arthritis - active, polyarticular rheumatoid arthritis, psoriatic arthritis and seronegative arthropathies
    • systemic vasculidities with joint inflammation
    • major multiple trauma
    • burns
    • congenital deformities

    Other diagnoses

    • complex spine surgeries
    • encephalopathy
    • Guillain-Barre
    • cancer
    • cardiac disease
    • deconditioning
    • diabetes with neuropathy
    • dialysis
    • Lupus
    • lymphedema
    • recovery from multiple system failure
    • pain management
    • post-polio
    • respiratory disease
    • spasticity

    Other information

    Patients CAN be admitted with medical treatments, comorbidities, or conditions as long as they do not interfere with the patient's ability to participate in the rehabilitationplan of care.

    Patients CAN have the following:

    • short-term heparin drip, IVs and/or piggybacks, tube feedings - continuous, bolus or nighttime
    • oxygen (NC, capable of using portable trach dome, face tent), nocturnal BIPAP, CPAP, tracheostomy (when not requiring frequent suctioning)
    • wound vac/drains (must be portable)
    • dialysis (3 times per week)
    • radiation treatment
    • IVIG (could be possible only if near end of treatment).

    Patients CANNOT have any of the following:

    • Need for remote telemetry
    • LE nerve infusion catheters (e.g., On-Q) if goals include LE mobility/ambulation.

    Admission criteria

    The following criteria must be met prior to admitting a patient to Courage Kenny Inpatient Rehabilitation.

    Medical stability

    • confirmed diagnosis
    • afebrile for >24 hours
    • no extremes of pulse, blood pressure, or respiratory rate
    • medical tests/procedures required for diagnosis have been completed
    • no medical or psychiatric problems that preclude full participation in rehabilitation program
    • not ventilator dependent
    • does not require telemetry
    • planned/anticipated removal of nasogastric tube for feeding, discontinuation of total parenteral nutrition, or discontinuation of continuous IV Heparin within 24 hours of admission.

    Rehabilitation readiness

    • Patient's special needs have been determined.
    • There are no behavioral of active psychiatric issues limiting the patient's ability to participate in the rehabilitation program.
    • Treatment for other co-morbid illnesses/conditions does not interfere with patient's ability to participate in rehab.
    • Probability of discharge to community setting confirmed at admit.
    • Patient is willing to participate in a rehabilitation program.
    • Patient must be able to participate in an intensive therapy program (e.g., 3 hours per day, 5-6 days per week).
    • Caregivers, if anticipated, are identified pre-admit and are willing and able to participate in the plan of care.

    Reasonable and necessary criteria

    • Services must be reasonable and necessary.
    • Patient must have potential to benefit from rehabilitation.
    • Expectation exists for significant functional improvement.
    • Patient requires close supervision by a physician with training or experience in rehabilitation.
    • Patient requires 24/7 rehabilitation nursing care.
    • Patient requires a coordinated interdisciplinary team approach to rehabilitation.
    • The patient must have disability or impairment in at least two of the following areas:
      • mobility impairment
      • difficulties with activities of daily living (e.g., bathing, grooming, dressing, feeding and toileting)
      • incontinence of bowel or bladder
      • inability to swallow safely
      • speech/language deficits (e.g., aphasia, motor speech difficulties)
      • perceptual impairment affecting safety or reasonable function
    • Patient must require at least two of the following rehabilitation services (one of which must be PT or OT):
      • physical therapy
      • occupational therapy
      • speech/language therapy
      • orthotics/prosthetics therapy

    Age

    • Courage Kenny Rehabilitation Institute admits adults ranging from 16 years of age (Abbott Northwestern Hospital) and 18 years of age (United Hospital) through geriatric (all ages).
    • Courage Kenny Rehabilitation Institute admits pediatric/adolescent patients on a case by case basis based on physician approval.

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    The programs at Courage Kenny Rehabilitation Institute do not discriminate based on race, ethnicity, religion, gender, or sexual orientation. We accept patients of various funding sources. These include, naming a few, Private Insurance, Worker's Compensation, Self-Pay, HMO/PPO, Medicare, In-state Medicaid, Out-of-State Medicaid, and CHAMPUS.


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