Over 300 nursing homes have closed since the beginning of the pandemic, and roughly 400 more are projected to close this year, according to a new report from the American Health Care Association and National Center for Assisted Living. This adds up to more than 1,000 nursing homes closing since 2015, requiring 45,000 nursing home residents to find alternative forms of care.1

Along with a dramatic change in reimbursement for skilled nursing facilities (SNFs) that lowered therapy utilization, this has pushed patients to seek other care settings as they recover from medically complex conditions.

Two care settings uniquely equipped to take on this patient population are freestanding inpatient rehabilitation facility hospitals (IRFs) and hospital-based acute rehabilitation units (ARUs). They serve as one of the leading methods of care for medically complex patients, and are the only service lines that provide daily intensive multi-disciplinary therapy. This is because acute rehabilitation is specifically designed to treat the complexities of today’s growing patient population, especially for those who require aggressive interventions to regain function.

Further, the American Heart and American Stroke Associations (AHA/ASA) recommends stroke survivors be admitted to an IRF instead of a SNF. The specialized care provided within this facility has been proven to generate positive outcomes both during and after a patient’s hospital stay.2

What impacts may be occurring at your hospital due to nursing home closures?

  • Increased medical-surgical length of stay
  • Re-authorization for payment challenges
  • Case management frustration
  • Decline in patient and family satisfaction

Additional benefits IRFs and ARUs offer to hospitals:

  • Increased clinical and quality effectiveness. Inpatient rehabilitation is known for producing exceptional clinical and quality outcomes, and reducing hospital readmission rates – benefiting the hospital as a whole.
  • Streamlined interdisciplinary team approach. Specialized care requires expertise from specialized clinicians, including highly-trained medical directors. Having the expertise within the hospital’s care continuum reduces the opportunity for errors while improving care consistency and transitions.
  • Improved patient throughput management. Having inpatient rehabilitation services available within a system’s care continuum helps ensure patients receive the right form of care at the right time in their care journey. This frees up needed staff and acute bed space and allows patients to efficiently and effectively progress in their recovery.

Through this specialized expertise and access to unique resources and data, IRFs and ARUs can improve hospital efficiencies, allowing more patients – including those coming from nursing homes – to receive proper care in a timely manner.



  1. The American Health Care Association and National Center for Assisted Living. . (2022, April 21). Nursing Home Closures: By the Numbers. https://www.ahcancal.org/News-and-Communications/Fact-Sheets/FactSheets/SNF-Closures-Report.pdf
  2. American Hospital Association. (2019). Fact Sheet: Inpatient Rehabilitation Facilities – A Unique and Critical Service. https://www.aha.org/system/files/media/file/2019/07/fact-sheet-irf-0719.pdf
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