From inpatient rehabilitation facility to skilled nursing facility to home: A retrospective study of functional recovery

Abstract

Background: Inpatient rehabilitation facility (IRF) care has an inherent goal of discharging patients back into the community. Some patients do not progress sufficiently and require discharge to alternate facilities. No prior studies have examined outcomes for patients requiring skilled nursing facility (SNF) placement after their stay at an IRF. Objective: To identify functional outcomes of patients who receive combined rehabilitation from IRF and SNF. Design: In this retrospective observational study, a semistructured phone call questionnaire evaluated for living situation and aid requirement at two time points: prior to acute hospitalization and following discharge from SNF. Setting: Inpatient rehabilitation facility. Participants: Persons who required postacute care stay at an IRF and who at time of discharge were not yet safe to return home, so instead were admitted to a SNF. Interventions: Not applicable. Main Outcome Measures: Changes in pre- and postmorbid functional status categorized by living situation and aid requirement. Results: Forty-three adults completed the study. After a stay at IRF followed by SNF, 58.2% of respondents returned to baseline independence. After IRF and SNF stay, 63.4% of respondents who lived at home prior to acute hospitalization returned home. Conclusions: The findings indicate that those patients who receive further rehabilitation at a SNF following discharge from an IRF have the potential to return to baseline functioning and subsequently return home. These data suggest that using IRFs in conjunction with SNFs might be an effective, patient-centered option for rehabilitation. However, further investigation is required to explore whether these findings may be generalized to a larger sample.