Study touts benefits of inpatient service over SNFs for therapy

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As Congress deliberates on the implementation of the 75% Rule, nursing home providers are disputing findings in a new report that calls the therapy regulation "counterproductive."

Patients with similar conditions and ages have better outcomes in inpatient rehabilitation facilities and at lower costs compared with those served in skilled nursing facilities, according to RehabCare, a rehabilitation service provider. St. Louis-based RehabCare serves patients in 118 hospital-based IRFs, about eight RehabCare-owned freestanding rehabilitation hospitals and approximately 1,100 SNFs.

The study does not arrive at sound conclusions because the company fails to adequately compare costs or outcomes of IRF stays versus SNF stays, said Susan Feeney, spokeswoman for the American Health Care Association. Study authors noted they could not evaluate functional gain from admission to discharge because both settings use different measures. Also, they acknowledged they did not address costs per se, only payment or expenditures as a surrogate for costs. The Oct. 23 report, while identified as "preliminary findings," is actually the report in full, according to Alan Sauber of RehabCare. More iterations likely are forthcoming, he said.

The Senate is expected to unveil Medicare legislation next week that could include freezing the 75% rule at a 60% threshold.

The report can be viewed at