exoskeleton outpatient physical rehabilitationRehabilitation occurs at a pivotal point in the recovery process, so choosing the appropriate level of care is important. While many healthcare providers describe their services as rehabilitation, the level and intensity of care can vary greatly from one to the next.

This chart provides an explanation of acute vs. subacute rehabilitation services. These resources will help determine what is best for you or your loved one. Prior to admission at our inpatient rehabilitation hospital, Sheltering Arms Institute, one of our clinical liaisons or physicians will assess the patient to ensure that he/she can benefit from intensive inpatient physical rehabilitation services and to arrange for the transition to our hospital if appropriate.

Acute vs. Subacute Physical Rehab Services

Inpatient Rehabilitation Hospital*Skilled Nursing FacilityLong Term Care HospitalHome HealthOutpatient Rehabilitation**
Length of TreatmentAverage 10-18 daysAverage 25 days25 days or longerVariable, based on treatment planVariable, based on needs
Therapy IntensityIntensive, skilled care; often integrating advanced technologiesLess intensive than inpatient rehabilitation, but not regulatedAs needed, usually low intensityVariable, based on treatment planVariable, based on needs
Amount of TherapyTypically 3+ hours per dayTypically 1-1.5 hours per day (up to 3 hours)Variable30-60 minutes per session & discipline, usually 3 times per week30-60 minutes per session & discipline, 2-3 times per week
Physician InvolvementDaily face-to-face assessment and treatment plan updateAt least every 30 daysAvailable, not on-site dailyProvide oversight but no direct treatmentAs needed to evaluate progress and assess treatment plan
Skilled Nursing Care – RNCare from RN 24 hours per dayRN on site for at least 8 hours/day, care typically provided by techs24 hours/dayAs needed per treatment planN/A

* Offered at Sheltering Arms Institute & Research Hospital
** Offered at Sheltering Arms Outpatient Rehabilitation Clinics

Inpatient Rehabilitation Facilities (IRF) vs Skilled Nursing Facilities (SNF)

For people seeking rehabilitation services, there are typically two options: An Inpatient Rehab Facility or a Skilled Nursing Facility. Below is a chart that outlines the differences between these options to help determine which option best meets the person’s current medical and rehabilitation needs.

ServiceInpatient Rehabilitation Facility (Hospital)Skilled Nursing Facility
Physician VisitsDaily1-3 times per week
Type of PhysicianPhysiatrist, a doctor who specializes in physical medicine and rehabilitation (24-hour availabilityGeriatrician, internist, or family practitioner (Limited availability)
ConsultantsAll specialties readily availableLimited specialist availability
Nursing Hours of Care5.5 and higher hours per day, primarily registered nurses (24-hour availability)2-3 hours daily, primarily certified nursing assistants
Nursing Skill MixProfessional registered nurses specializing and certified in rehabilitation nursingNursing assistants certified in long-term care with LPN/RN supervision
FunctionComplex level of care, patient and family educationBasic level of care support
Integration of CareCoordinated multidisciplinary team directed by physicianSeveral individual disciplines
Average Length of Stay10-35 days, depending on diagnosis24-60 days
Therapy Intensity3 hours per day, 5 days per week45-90 minutes, 3 times per week
Team MeetingsMultidisciplinary team meetings lead by physician including familySeveral individual disciplines
Physical and Occupational TherapyRegistered physical and occupational therapistsPhysical therapy assistants and certified occupational therapy aids deliver much of the care
Audiologist, Therapeutic Recreation, Social WorkerFull-timeLimited
Speech Language TherapistFull-timeLimited
AccreditationJoint CommissionNone
Quality ImprovementQuality Assurance/Utilization ReviewNone
Driver TrainingFull-timeNone
Prosthetist/OrthotistEvaluated by licensed clinician and accepted by medical doctorAccepted by admissions

Sources: DaVanzo, J. E., Ph.D., M.S.W., El-Gamil, A., Li, J. W., Shimer, M., Ph.D., Manolov, N., Ph.D., & Dobson, A., Ph.D. (2014). Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge [Abstract].

What is Inpatient Rehabilitation?

Inpatient rehabilitation refers to physician and therapy services received during a hospital stay. The majority of our patients come to us after being stabilized at an acute care hospital, but others are admitted directly from the community. Patients participate in intensive therapy for at least three hours a day, five or more days a week using cutting-edge rehab technology.

What are Typical Inpatient Diagnoses?

Diagnoses may include amputation, brain injury, cancer, generalized weakness, multiple joint replacement, multiple sclerosis, neurodegenerative disease, neuromuscular disorder, spinal cord injury, and stroke. Patients often have multiple medical complications that must be effectively managed to enable them to participate in therapy and set the tone for ongoing recovery. 

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