ASCP 2020 Recap: Acute Rehab’s Pandemic Response

By Sally Brooks, MD, CMO

Recently, I had the great opportunity to join some of my industry colleagues on a panel at the annual meeting of the American Society of Consultant Pharmacists. This year’s theme, a focus on healthy aging, struck a balance between the work that Kindred Hospitals across the country are doing every day and the global pandemic that is before us. In my panel session, I had the opportunity to speak about Kindred’s response to the pandemic, from preparedness to changes along the way, and where we can predict the future of post-acute care.

ASCP 2020

As you may know, rehab has proven to be essential for the full recovery of patients following an elective surgery or an injury, and is now shown to be essential as patients proceed past an active coronavirus status. Alternatively, many patients whose illness warrants an inpatient hospital stay and will need rehabilitation after discharge may be too weak to tolerate the usually required three hours of therapy per day.

To combat this issue, several CMS and MA plan pre-authorization waivers allowed artificial barriers to be removed such as:

  • 60% rule (% of patients with CMS rehab-specific diagnoses)
  • Required three-hour therapy rule
  • Burdensome health plan pre-authorization processes

AIR (acute inpatient rehabilitation) hospitals were also provided key federal regulatory waivers during this national health emergency, enabling them to take on medically appropriate patients and free up critical hospital and ICU beds for COVID patients.

As a result of these efforts, acute inpatient rehabilitation units have been able to accept and care for appropriate rehabilitation patients (including COVID-recovering) with increased timeliness while delivering great outcomes and adding value to patients, payers and health systems.

Post-COVID-19 patients in Kindred partner inpatient rehabilitation hospitals and acute inpatient rehabilitation units have recovered faster than those in other rehab programs, as compared by using UDS – the national database benchmarks. These partner facilities, during a time of reduced med/surg census in acute care partner hospitals, have experienced a more stable acute rehab census during the pandemic and provided critical rehab care to a greater number of patients.

At the onset of the pandemic, Kindred took several operational measures to ensure patients, providers, staff and family remained safe. Some of these measures included:

  • Taking swift and nimble action before Public Health Emergency declared
  • Developing daily Incident Command Task Force to address/strategize on all COVID-19-related matters, including:
    • Clinical response, lab testing and PPE
    • Patient discharge planning with referral sources
    • Workforce policies, staffing and labor contingency planning
    • Daily newsletters for each line of business to increase communication outlets

Looking ahead, it’s important to think about how the post-acute care space will continue to evolve. Will we see increased needs through the supply chain? Will the CMS administrative burden be increased or decreased? And most importantly, how will our patient population evolve?

If you’d like to learn more about Kindred’s key findings through COVID, please feel free to reach out to me.

By Sally Brooks, MD, CMO