By Tiffany Lai August 13, 2023
Here are some common discharge options across hospitals from most intensive therapy to least.
Acute rehab
A rehab setting delivering short term aggressive therapy with the goal of the patient returning home afterward. The patient needs to be able to tolerate 3 hours of therapy a day, 5 days a week for about 2 weeks. The patient needs to be motivated, have enough stamina to participate, and have a potential to improve rapidly. It’s a plus if they have support at home. Usually good for neuro patients and complex orthopedic patients. This setting has similar supports to a SNF with nursing staff, doctors, nursing aides and therapists.
Skilled nursing
This is generally for patients who are unable to return home safely for a number of reasons:
- Their mobility may not sufficient for them to enter or mobilize to needed areas in their house
- They don’t have anyone to care for them at home but they require help
- The help they require exceeds what their caregivers can handle
The stay at a SNF can be longer than ARU. Patients that qualify for medicare have 100 days annually. Some patients may start here and later go to ARU.
Home health
Patients are able to return home safely but needs a therapist to come to their home to continue rehab. They may have a challenging environmental barrier at home, need additional DME or caregiver training with their home setup, or require continued therapy but has difficulty traveling to an outpatient clinic.
Outpatient
The patient can return home and is able to travel to a clinic. Outpatient clinics can be more specialized to the patients needs. Outpatient rehab clinics range from cardiac outpatient, neuro outpatient, hand therapy, BPV clinics etc.
Home
When the patient is independent or has plateaued with their therapy progression. The patient and caregivers should know how to perform any followup home exercises and the caregivers confident in how to assist the pt with ADLs. Sometimes this is the discharge disposition for patients on hospice.
Medical respite
Patient need to be able to perform ADLs and mobility with supervision. This center will assist with medication management for a bit. The patient will not be able to stay very long here before discharging to a shelter.
Shelter
For unhoused patients. Patients will need to be Independent or Modified Independent with ADLs and mobility.