Although health systems around the country are integrating new care approaches to effectively treat the growing medically complex patient population, location continues to be an important factor, often hindering patient access to vital services.

Both urban and lower-populated communities have unique attributes that make them exceptional places to live. However, the lack of access to high-quality healthcare, such as acute inpatient rehabilitation, has created a variety of obstacles and missed opportunities to provide high-quality, convenient care to those who need it most.

Non-Urban Community Challenges and Opportunities

Acute rehabilitation units (ARUs) within local hospitals play an essential role in their communities, as rural hospitals serve roughly 20% of the nation’s population.1 However, some are beginning to struggle financially due in part to low retention and recruitment challenges, making up 65% of the nation’s workforce shortages;2 and lack of specialized expertise. Challenges within the patient pre-admission screening process also impact patient volume. Since it has become difficult to hire and train highly-specialized rehabilitation staff, it can become difficult to effectively identify and admit the right high-acuity patients at the right time in their care journey. Without the proper identification of patients who meet the appropriate criteria for inpatient services, many patients receive treatment in urban communities – further compounding the patient shortage.

There are proven strategies that can enhance non-urban hospital performance, achieve greater patient reach and ultimately keep patients closer to home when receiving care. These include:

  • Implementation of education and resources to help community members understand the importance of having access to services such as acute rehabilitation and how it can aid in early identification of illness and more effective treatment.
  • Integration of highly-trained clinical liaisons to quickly identify patients in need of inpatient rehabilitation and help educate referring providers and patients about the high level of services offered, so patients can continue to receive treatment close to home and aren’t referred to urban areas to receive treatment.
  • Having a team experienced at identifying and recruiting specialized resources can help address staffing shortages and assist in retaining top rehabilitation talent.
  • Integration of innovative solutions, such as telehealth and Ekso Skeleton robotic technology, to help ensure all aspects of a patient’s care journey are addressed and the hospital is equipped to treat all levels of patients within their community and avoid patients seeking treatment in urban communities.
  • Partnering with an acute rehabilitation industry expert who specializes in treating the growing medically complex patient population. Inpatient rehabilitation is incredibly specialized. Partnering with an expert can relieve the burden of running rehabilitation and allow the hospital to tap into both local and national resources and data they might otherwise not have access to.

Although rural communities are faced with various obstacles when it comes to providing high-quality inpatient rehabilitation care, urban communities also have their own unique set of challenges.

Urban Obstacles and Opportunities

For non-urban residents, having access to vital healthcare services is due in part to physical distance, whereas urban communities are often faced with overcrowding. In addition, the recent closing of over 120 community-based hospitals has led residents to seek care in urban communities, which has further strained hospital capacity and led to a shortage of specialized staff to meet the growing need.

This issue is also compounded by the fact that many urban hospitals are not equipped to handle the growing volume of patients with multiple comorbidities. Similar to rural hospitals, urban health systems are experiencing talent shortages due to the high volume of patients in need of care, and the already competitive hiring market. Getting the patient the right care at the right time in their recovery journey is critical. Hospitals sometimes lack the specialized expertise to quickly determine what post-acute treatment plan is best for a patient and when a care transition is necessary for both patient and hospital outcomes.

Fortunately, there are strategies local health systems can integrate to effectively address these challenges so they can best meet the needs of all those within their community.

Urban hospital strategies include:

  • Offering the latest innovative solutions that provide unique benefits to effectively and efficiently treat the growing number of medically complex patients. This will enable urban hospitals to stay competitive amid a highly saturated healthcare environment as well as create a positive and more effective recovery plan for patients.
  • Obtaining highly specialized rehabilitation expertise to meet the high patient volume in an effective manner while simultaneously helping to lower average length of stay and reducing readmission risk.
  • Implementation of highly-trained clinical liaisons to help identify the right patients at the right time in their care journey. This will help ensure a hospital is effectively using resources to get patients the exact care they need and avoid unnecessary care costs.
  • Utilizing an experienced appeals and denials team to help overcome increasing denial rates and navigate the ever-changing healthcare landscape.
  • Expanding inpatient services to meet the growing needs of medically complex patients. Market expansion allows patients to stay within the health system throughout their care journey – helping to enable greater patient satisfaction and outcomes.
  • Entrusting hospital or unit management to an acute rehabilitation management partner who is equipped to address a wide variety of patient needs. This allows a hospital to remain focused on its core competencies while still providing the high-quality, tailored care needed to treat high-acuity patients, creating a domino effect of improved hospital outcomes, reduced readmission risk and lower overall care costs.

Through these strategies, local health systems can better address the challenges presented in their communities to help ensure care is accessible to all patients within their community. Moreover, having an experienced partner in the rehabilitation space allows a hospital to focus on core business competencies while the partner provides a specialized care approach to address specific needs within the community.

To learn how Kindred can help your hospital expand acute rehabilitation access to your local community, visit


  1. Rogan, E., & Lewis, J. (2020, January). Rural health care: Big challenges require big solutions: AHA News. American Hospital Association | AHA News.
  2. Bolin, J., & Bellamy, G. (2020). Rural Healthy People 2020. College Station; Texas A&M Health Science Center.
By Kindred Hospital Rehabilitation Services