How to build a successful rehab program

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Christopher M. Bird
Christopher M. Bird

According to a 2010 report published by Health Affairs, 10.9 million community and 1.8 million nursing center residents need rehabilitative services in the United States each year. Rehabilitation has long been an integral part of nursing centers and is garnering additional interest as more sub-acute services transition to the long-term care setting. Yet despite the overwhelming support for the value of rehabilitation services, significant changes are on the horizon.

Industry experts project that reform related to MDS 3.0 and RUG IV could result in facilities losing up to $25 per Medicare resident per day, which has prompted some long-term care facilities to put key programs on hold. This doesn't need to be the case.

Well-orchestrated rehabilitation programs present an immediate opportunity to achieve increased operational excellence in providing quality outcomes in a cost-effective setting. But what takes a rehabilitation program to the next level?

Most rehabilitation providers can deliver the fundamental skills of therapy, but optimal providers raise the bar by guiding partners through confusing regulatory sanctions, and demonstrating how to make rehabilitation services a fundamental part of business operations that positively impacts census development. The best rehabilitation teams are integral partners in planning, implementing and measuring the progress of the program. The following summarizes the essential elements of building a first-rate rehabilitation program:

10 Essential Steps to Improving the Value of Rehabilitation Services

1. Build your rehabilitation program around quality people.

* Hire and retain therapy professionals with appropriate qualifications.

* Identify and leverage the specialized skill sets of each therapist.

* Invest in ongoing education, leadership development and mentoring initiatives.

2. Partner with a rehabilitation provider that understands and has experience with operating long-term care centers.

* A true business partner invests in your business and shares in the risk and reward.

3. Develop specialized rehabilitation programs that meet the needs of the facility and community.

* Assess needs of resident population and community.

* Provide a variety of clinical programs that support clinical outcomes and business growth.

* Develop and market programs not readily available in your market.

4. Provide excellent therapy management.

* On-site rehab management provides leadership beyond staffing and scheduling, including effective implementation of these 10 steps.

* Establish a collaborative approach with interdisciplinary and operations teams.

* Leverage expertise with best-practice strategies and tool kits.

5. Make sure therapy providers know the rules—and follow them.

* Routine changes in state and federal regulations require constant attendance and oversight.

* Documentation competency, audits and multilevel oversight provides support for business growth.

6. Know your customer.

* Enhance census development: Develop customer profiles and understand needs

* Use a menu of approaches for establishing excellent customer relations.

* Promote services and collaborate with facility on community education to local organizations.

7. Earn the referrals, ask for the business.

* Develop referral relations strategies.

* Provide reliable clinical outcome data.

* Share “great stories” regarding outcomes.

* Differentiate your services and ask for business with confidence.

8. Make it easy for your customers to admit to your center.

* Develop the pathway of least resistance—keep the admission process simple.

9. Manage the rehab stay.

* Communicate anticipated clinical pathways from the time of admission throughout the stay.

* Manage expectations related to the length of stay and rehab potential from admission to discharge.

10. Keep your customers happy.

* Keep physicians current with therapy progress.

* Don't assume your customers know what you are doing well; inform them on a regular basis.

* Share patient satisfaction results with referral sources.

The risk/reward of partnering with a successful therapy provider is too great to delay making a formal assessment of your current program. Properly deploying a “best practices” rehabilitation program—and then knowing how to measure and market your outcomes data to key audiences— are essential to increasing census development, and, ultimately, revenue to grow your rehabilitation business in 2010 and beyond.

(The complete white paper called “10 Ways to Grow Your Rehab Program in 2010” can be obtained by contacting

Christopher M. Bird is the president of Peoplefirst Rehabilitation, a national staffing and management firm of rehabilitation departments at over 600 nursing centers and hospitals.

Guest Columns

Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.