Inpatient Rehabilitation Admission Process
Admission to the inpatient acute rehab program requires the potential patient to meet certain qualification requirements. Previous medical history, current medical condition and the need for and the ability to participate in intensive multidisciplinary therapy determine whether a patient can be accepted to the rehab unit.
Patients are admitted to the inpatient rehab unit from UW Hospital and Clinics and from other referring hospitals. Admission criteria are highly regulated by the Centers for Medicare and Medicaid Services (CMS) and other payment sources.
How to Refer a Patient
Patients may be referred by a physician, a case manager, family members or other health care professionals. At the time of referral, our consult nurse will ask for specific information about the patient's illness or injury, insurance information, and who will be the point of contact.
The consult nurse and a rehabilitation physician will view the patient's medical history to determine if the patient meets the criteria for admission. The rehab unit must obtain the medical records from the referring hospital. The consult nurse will serve as the primary contact person and notify the referral source of the admission decision.
Criteria for Admission
- Need an intensive inpatient hospital rehabilitation program
- Need close medical management by a rehabilitation physician
- Need 24-hour rehabilitation nursing
- Need an integrated multidisciplinary coordinated team approach to rehabilitation
- Be able to actively and willingly partake in and benefit from an intensive program of rehabilitation, consisting of a minimum of three hours of skilled therapy (occupational therapy, physical therapy, speech pathology and/or orthotic services) five days per week
- Demonstrate the potential for significant practical improvement
- Have realistic goals requiring inpatient rehabilitation
- The patient should have no significant medical issues that would jeopardize the patient's well being if he/she actively participates in an intensive rehabilitation program, or preclude full participation
- The patient and family (if applicable) are in agreement with the admission and the rehab plan of care
Coverage for inpatient rehabilitation varies among insurance policies. Our inpatient Admissions Office (the Access Center) will work with the patient, family and insurance carrier to obtain the necessary coverage information, verification and authorization of benefits. UW Hospital and Clinics accepts most major health insurers. Any financial obligation for the patient will be discussed prior to admissions.