Admission Criteria

For Inpatient Admission (must meet ALL)

  • The patient needs an intensive inpatient rehabilitation stay due to the complexity of their nursing, medical management, and rehabilitation needs.
  • The patient will benefit from an interdisciplinary team approach to the delivery of rehabilitative care.
  • The individual must be able to tolerate and benefit from a minimum of three hours of therapy per day at least five days per week including physical therapy, occupational therapy, and/or speech therapy. In some cases as indicated by the needs of the patient, 15 hours of therapy can be provided over the course of a 7 day consecutive period.
  • The patient must be reasonably expected to actively participate in the benefit from the rehabilitation plan.
  • The patient must be at least 18 years old.
  • The patient must require physician supervision by a rehabilitation physician defined as a physician with specialized training and experience in inpatient rehabilitation where there must be at least three weekly documented visits.
  • If it appears the patient may require post-discharge support, options will be discussed with the patient/family prior to admission.
  • If the patient has already completed a rehabilitation program, they may be considered for re-admission if the following conditions are met:
    • The individual meets the general admission criteria.
    • The individual has sustained a new event, injury, or change in function.
    • The individual has rehabilitation goals that were not achieved but are currently feasible.
    • The level of care required by the individual can reasonably be expected to be reduced by an intensive rehabilitation effort.
acute rehab admission

For Continued Stay (must meet ALL)

  • Every patient should have specific and definite rehabilitation goals documented on the treatment plan within 4 days of admission.
  • The patient continues to need an intense rehabilitation program with an interdisciplinary approach, which includes at least two therapeutic disciplines.
  • The patient continues to make progress towards stated goals and continues to tolerate at least three hours of therapy daily.
  • The patient needs treatment modification based on goal progress with documentation of discharge planning reflecting patient/family involvement.
  • The patient develops a complication that temporarily impairs the progress of the patient toward their stated goals for less than one week. Rehabilitation and treatment, though they may be less intense, are still necessary and ongoing. These situations will be evaluated on a case-by-case basis.
  • The patient continues to need rehabilitation physician and nursing plus supervision.

For Discharge (must meet ONE)

  • The patient achieves maximum benefit towards goals stated on the treatment plan.
  • The patient develops a medical, surgical, or psychological complication that precludes benefit from continued intensive rehabilitation efforts, or develops a complication that is better treated at another level of care.
  • Patient and/or family are no longer willing to be active participants in the program.
  • The patient’s functional status has remained unchanged for the period of time determined by protocol for the diagnosis.
  • The patient no longer requires at least two therapeutic disciplines.
  • The patient no longer requires, or is unable to tolerate, at least three hours of therapy per day and rehab physician oversight.

Patients who are unacceptable for admission are

  • Patients who do not meet admission criteria outlined under General Admission Criteria.
  • Patients with an active psychosis which prevents participation in the program.
  • Patients receiving courses of radiation therapy and/or chemotherapy or dialysis will be considered for admission on a case-by-case basis.
  • Patients who have airborne precaution isolation.

Patients who may be denied admission are

Patients that meet medical criteria outlined under General Admissions Criteria but do not have a qualifying diagnoses under the Medicare Rehabilitation Impairment Category (RIC) categories for Prospective Payment System may be denied admission if compliance with 60% rule is not at the recommended level.

Patient Evaluation Period

All admissions are provisional. A Pre-admission Assessment must be completed within 48 hours prior to admission to determine if the patient meets medical necessity criteria for Inpatient Rehabilitation Facility level of care.

  • The patient must meet all admission criteria at the time of admission.
  • Admissions are made with the referring agency, physician, and/or responsible party’s knowledge and consent that an evaluation period will occur to determine the patient’s potential.
  • Arrangements may then be made for the patient’s transfer to a more appropriate level of care for individuals who are not appropriate for acute rehabilitation.
  • Patients who do not meet admission criteria outlined under General Admission Criteria.
  • Patients with an active psychosis which prevents participation in the program.
  • Patients receiving courses of radiation therapy and/or chemotherapy or dialysis will be considered for admission on a case-by-case basis.
  • Patients who have airborne precaution isolation.

For Patient Assessment

During your stay here, your progress will be evaluated on an ongoing basis. The information collected is part of your medical record. Rehabilitation Hospital of Indiana will use the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) as part of that assessment, when evaluating your clinical status. Your rights regarding this data collection are:

  • To be informed of the purpose of the assessment data collection as part of the reimbursement process.
  • To refuse to answer patient assessment data questions if you wish.
  • To See, review, and request changes on the assessment instrument