Falls Village on rehabilitation professionals you can trust – LIVING WELL Magazine

Choose rehabilitation professionals you can trust

By Greg Carnes, MBA, LNHA, Falls Village, Akron LIVING WELL Magazine

After hospitalization, many older adults require care for short-term rehab to home. In the current fragmented health care system, hospitals are financially incentivized to discharge patients to post acute care as soon as possible. As a result, in some cases, older adults are caught in a system that transitions patients to home, home health, outpatient care or a skilled facility in a manner that causes various adverse medical, social and financial consequences.

Care management on all levels of illness or injury is the key to managing this process for a more efficient and effective outcome. Intervention and communication at each stage of the hospital to home progression is the only way in our current health care environment to succeed. Discharge planners and social workers on level of care must consider the determinants for each patient in the decisions to discharge to a skilled rehabilitation center, or to home, with home health care services. This will go a long way to successfully realize the best outcome for that patient.

The statistics of discharges are surprising. Twenty-seven percent of older adults discharged from a hospital require care in skilled nursing facilities, with an additional 15% requiring home health care services.* Older people with complex medical needs and inadequate social support are more likely to require a skilled nursing center. For many older adults, these facilities provide lifesaving services. For others, skilled nursing services can be provided at home. In either case, a knowledgeable professional needs to be involved to establish goals and guidelines for that particular individual. That professional also should be the communicator with family and loved ones regarding questions, emotional issues and to sort through the confusion that comes along with our current structure.

Where can you find these professionals to ensure that you or your loved one will receive the best health care track? Look for those companies who partner with one another to make it happen. If your recommendation is a skilled rehab facility, find out who does the therapy within that facility. Who manages the care of the patient once they are in the facility? What is their return-to-home rate and how will they make it happen for you or your loved one? If your recommendation is home health care, find out who that company partners with for outpatient therapy for successful progression to optimum health. Who will they send that patient if the episode deteriorates? Who would make the family most comfortable? What is their success rate with that specific therapy? These are important questions and should be addressed before the day of discharge from the hospital in order to make the move to the next level as effectual as it can be in this emotional and painful time.

We are moving closer to the federal government’s Accountable Care Organization model. You will notice health care organizations collaborating to find ways to streamline the process and help transition patients to the appropriate care levels. The goal is to continue to provide a quality health care experience where the patients can access top notch services while reducing the strain on the current system of reimbursement. In your search for rehabilitation or long-term care, ask for visionary companies with those partnerships. Those companies will be the ones with the professionals who will be dedicated to getting you or your loved one through the baffling puzzle of health care today and return them where they want to be… healthy and home.

For further information, or to talk about our programs, please call Shannon at Falls Village, Debbie at Magnolia Village or Gina at Medina Village.

*Institute of Medicine 2008