Choosing an Acute Rehabilitation Hospital
Rehabilitation is the bridge between hospital and home. It’s all about helping you reach your maximum health and recovery.1 There is no formula to successful rehabilitation; it is a process tailored to the needs of each patient. “Rehab” works best when it is a collaboration between a person with a spinal cord injury and a team of experts in medicine, psychology, social services and technology.
One of the most essential decisions a person with a new spinal cord injury has to make is where to go for rehab. It’s also one of the earliest decisions to be made. Rehab is the stage of care that will prepare you for the long term – getting your body back into the best shape possible, making sure you know how to take care of your health, and maximizing your independence. So it’s very important to find the best place to receive the best care.
There are several factors that will affect your decision of where to go for rehab. Each person’s situation can be very different. The following is an overview of some of the considerations that may come into play when you decide which rehab facility to choose.
First, how much time do you have to decide? Maybe just a few days. The sooner rehab starts the better, and lengths of stay in acute care are getting shorter. In the 1970s a person with a spinal cord injury was kept in an acute hospital setting for about 24 days. That’s down to an average of 11 days now, depending on complications, infections, etc.
Next, you should seek a place that is most suited to your injury and needs. California has several acute rehab “units” that specialize in treating persons with spinal cord injury and, of course, there are units outside of California that also might be appropriate. One way to start your search is to look to accredited California units.2 This generally means that the provider has demonstrated conformance to internationally accepted standards of care. The Commission on Accreditation of Rehabilitation Facilities (CARF) is an organization that certifies rehabilitation facilities. CARF prepares a list of specialty SCI units that you can review.
There are 14 SCI Model Systems Centers in the U.S. These are federally funded rehabs that also provide research. These centers offer comprehensive care in a specialized setting.
While the closest place may be the most convenient, with advantages of support from family and friends, it may not offer the level or quality of service your specific injury requires. A less specialized but more convenient facility may welcome a new SCI patient – they like to keep the beds full – but the rest of the ward could be people who have had injuries very different from your own and the staff might have far less experience with your type of injury.
Rule of thumb: the best rehabilitation units for people who have had a spinal cord injury are very specialized, offer a comprehensive treatment plan, and see a lot of patients with similar spinal cord injuries.
Practically speaking, your choice of rehab setting may be determined, or at least greatly affected by, your health care insurance. Contacting your insurance company will allow you to learn more about what is covered. Catastrophic injury insurance comes with many variations of coverage and deductibles, and perhaps limits on payments. If possible, you may want to get a copy of your policy documents. When you do, read the fine print. It won’t take long to discover that caring for spinal cord injury is very complicated, and very expensive.
Important question: are you a veteran of the U.S. military injured in combat? If so, you may be eligible for rehab and medical care from the Department of Veterans Affairs, which operates specialty centers for SCI. To find out if you are eligible for VA services, visit this website.
When you or your loved ones begin to narrow the search for a rehab, contact each center. All centers should have staff trained to answer the basic question: Am I covered by my insurance here? Look at the process as you might choose a college. Although people don’t always make site visits to rehab centers, if you or someone you know can do so, you should.
No insurance? According to the SCI data, fewer than half of people with SCI have private health care insurance at the time of injury. Alternative payment sources including proceeds from a lawsuit may be available in some circumstances, but their availability is far from certain and must be investigated on a case by case basis.
Questions to Ask
Some of the questions to ask when choosing a rehabilitation center include:
- How much experience does the facility have with SCI?
- How many patients like me does the facility see per year?
- What is the staff to patient ratio?
- How long do people with injuries like mine stay in rehab?
- What sort of programs are available – driver training, sexual health, psychological services?
- Is the facility accredited – does it meet professional standards of care for spinal cord rehab?
Deciding on a rehabilitation hospital after a spinal cord injury adds urgency to an already stressful situation. It’s an important decision, though, so make it a priority.
See what your options are, understand what insurance will and will not cover, and try to weigh the pros and cons of rehab units for your particular situation. Consider strongly, if available, a rehab unit that has been accredited in the specialty of SCI.
1This article is not legal advice or advice on which rehabilitation unit is right for you nor does anything herein constitute a guarantee, warranty or prediction regarding the outcome of your legal matter.
2To be awarded CARF accreditation, a facility must have specific staffing and programs, and must pass an in-depth review of its services. The highest level of certification in spinal cord injury rehabilitation is to be designated a U.S. Model Systems SCI Center. There are 14 such centers in the U.S., with just one in California. Some Californians with SCI leave the state for rehab at one of the Model Systems centers, or other rehab units in the U.S. In this case, you may lose local community support, and add a lot of detail regarding travel and logistics.