AMPRA and ATI 2021 report

The ongoing critical role inpatient rehabilitation plays in medically complex and COVID-19 patient recovery

Recent analysis from the American Medical Rehabilitation Providers Association (AMRPA), in partnership with ATI Advisory (ATI), further highlights the critical role inpatient rehabilitation hospitals (IRFs) have played and continue to play throughout the pandemic. This report is a follow-up of a previous ATI analysis published in early 2021, detailing the growing importance of IRF utilization for short-term acute care hospital (STACH) outcomes. It also highlighted the heavy reliance of STACHs on IRFs to relieve capacity constraints, as well as admit and support patients with more intensive needs without disruption.

This new research references IRFs as being “the cornerstone of post-acute care” as they continue to generate optimal outcomes for complex patients with medical, rehabilitative and behavioral health needs. This further underscores the importance of inpatient rehabilitation resources that can quickly deliver capacity and share resources to help ensure safe, timely and effective healthcare.

“The physician-led care, clinical competencies and infection control protocols employed by inpatient rehabilitation hospitals and units made our hospitals uniquely situated to address the critical hospital capacity issues during the pandemic. These are also the same factors that make inpatient rehabilitation a distinct and essential component of the post-acute care continuum outside of a public health emergency,” stated Anthony Cuzzola, AMRPA Board Chairman.

When asked about the flexibility requirements promoting the fundamentals of post-acute care both during the past two years and in the future, ATI Advisor and research lead Conner Esworthy stated, "Federal waivers and prior authorization relief seem to offer a space for quicker clinical decision-making typically obscured by administrative barriers. These flexibilities should remain part of the health system's public health emergency arsenal to better utilize existing institutional capacity."

Looking ahead, IRFs have the opportunity to both participate in and lead initiatives within post-acute care beyond the pandemic. This is made possible through the value they provide, including:

  • Distinguished medical capabilities. Throughout 2020 and 2021, IRFs needed to shift their capacity rates based on the needs of their community. This included admitting both COVID-19 patients and non-COVID patients.  IRFs were able to provide value to the care continuum by quickly admitting patients who had become increasingly more complex in their illnesses.
  • Embraced technology. IRFs utilized telemedicine for both inpatient and outpatient services. The need for innovation to enhance patient care and staff safety accelerated the implementation of virtual models that otherwise would have taken much longer outside of a pandemic environment.
  • Improved patient care. As the medically complex patient population increased – coupled with strict infection control protocols – IRFs had to efficiently and effectively reassess how they could admit and treat patients within their settings. An IRF’s willingness to adapt and implement new models has generated more informed decision-making across discharge pathways, staffing and care techniques.
  • Effective infection control protocols. Throughout COVID-19, IRFs continued to showcase their ability to quickly elevate their infection control protocols. Research highlights that this initiative greatly contributed to rapid admissions of patients from STACHs and improved outcomes for both COVID-19 and medically complex patients.

There is no question that the pandemic has placed unparalleled strains on the healthcare system as a whole. As IRFs continue to lead the industry in treating both COVID-19 and medically complex patients, their value will only continue to increase and implementation of this service line with become even more essential for hospital outcomes. 

To learn more about AMPRA and ATI Advisory’s findings, click here.


  1. The American Medical Rehabilitation Providers Association (AMRPA) and ATI Advisory (ATI). (2021, December 14). New research finds inpatient rehabilitation hospitals offer critical capacity to COVID-19 and non-COVID Patients. Yahoo! Retrieved December 15, 2021, from
By Kindred Hospital Rehabilitation Services