Inpatient Rehabilitation Facilities (IRF) (also known as Inpatient Acute Rehabilitation) week 4 pre class readings

IRF (abbreviation)

Inpatient Rehabilitation Facility (also known as inpatient acute rehabilitation)

Primary focus of an IRF

Providing intensive rehabilitation to individuals with one of 13 identified conditions

Two structural types of IRFs

Freestanding rehabilitation facilities and specialized units within acute care hospitals

Mandatory medical leadership position in an IRF

Medical Director of Rehabilitation

Required availability of medical and nursing care in an IRF

24 hours a day, 7 days a week

Mandatory medication-related service in an IRF

Prescription medication services and management

Mandatory rehabilitation therapy disciplines in an IRF

Occupational therapy, physical therapy, and speech and language therapy

Additional optional services provided by an IRF

Psychology, social work, nutrition, therapeutic recreation, orthotic/prosthetic, driving rehab, and adaptive equipment services

First major admission criterion for an IRF

The patient must be medically stable

Daily therapy tolerance requirement for IRF admission

A minimum of 3 hours of therapy daily, 5–7 days per week

Minimum number of therapy disciplines required for an IRF patient

Services from 2 or more therapy disciplines

Factors determining an IRF patient's length of stay

Diagnosis and co-morbidities

The IRF 60% Rule

A requirement that at least 60% of an IRF's admitted patients must have one of 13 qualifying diagnoses (originally conceived as the 75% Rule)

Qualifying diagnoses under the IRF 60% Rule

Stroke, SCI, congenital deformity, amputation, major multiple trauma, hip fracture, neurological disorders, brain injury, burns, polyarticular RA, systemic vasculidities, severe/advanced OA, and qualifying joint replacements

Neurological disorders qualifying under the IRF 60% Rule

Multiple sclerosis, motor neuron disease, polyneuropathy, muscular dystrophy, and Parkinson's disease

Criteria for a joint replacement to count toward the IRF 60% Rule

Bilateral procedure, BMI >50, or patient age $\ge 85$ years

Reimbursement system used for IRF admissions

Prospective Payment System (PPS)

Base element established by the Prospective Payment System (PPS) for IRFs

A base payment rate for IRF admissions

CMG (reimbursement acronym)

Case-Mix Group

Factors that determine a patient's Case-Mix Group (CMG)

Primary reason for admission (diagnosis), age, and level of function

Effect of Case-Mix Groups (CMGs) on IRF reimbursement

CMGs are weighted and used to adjust the base payment rate

Reason for geographic variation in IRF base payment rates

Adjustments for geographic differences in labor and operational costs

IRF-PAI

Inpatient Rehabilitation Facility-Patient Assessment Instrument

Timing of IRF-PAI completion

At admission and at discharge

Process of completing the IRF-PAI

Interdisciplinary team members each enter information related to their specific practice area

Section GG of the IRF-PAI

Functional activities and roles

Primary requirement for completing the IRF-PAI

It is mandatory for facility reimbursement