10 Steps to Optimize Your Hospital’s Rehab Program

With greater emphasis being placed on care transitions and readmission rates, inpatient rehabilitation programs have the incredible potential to become high-performing centers of excellence that optimize the performance of the entire hospital. Rehabilitation is so critical because it is key to patient recovery for medically complex patient populations that continue to grow as the population ages, and essential in reducing readmissions and associated financial penalties.

However, maintaining a well-run rehab unit is complex and requires specialized expertise.

This paper outlines the 10 steps hospital executives can take to maximize the performance of their rehab program and position their organization for continued success.

Many units today do not reach their full potential because operational expertise and resources are difficult to develop and maintain. There are a multitude of regulatory requirements – including the three-hour rule and the 60/40 regulation – that make compliance and efficient care delivery a challenge. By following the outlined 10 steps, rehab programs can thrive, and drive greater value to their hospital and most importantly their patients.

Overall Performance


1. Assess the performance of your inpatient rehab program.


How does your performance compare to that of high-performing inpatient rehab programs? Analyze and benchmark internal admissions and discharges, external admissions, internal costs, 60/40 compliance, CMI, FIM gains (functional improvement), CARF/Joint Commission survey results and financial performance. Ensure the availability of training and orientation for medical directors and staff and a business plan for the program.

2. Evaluate internal and external market demand for rehabilitation services.

What percent of your med/surg patients who need rehab services are discharged to your inpatient rehab program and to local SNFs? What diagnoses? Growing market share in an increasingly competitive environment can be challenging. Understanding internal and external opportunities and implementing strategies to capture downstream business will increase market share and stabilize program volume.

3. Determine strategic direction for your rehab program.

Should you expand your rehab program? Should you consider opening a rehab program? Often rehab programs are siloed and not fully integrated as a critical component of a hospital’s services. A rehab program provides a seamless transition for patients in need of intensive, quality rehab services and contributes to the hospital’s financial performance, while boasting low readmission rates back to acute care.

Operations and Census Development

4. Ensure appropriate leadership expertise.

Program directors must have expertise, beyond staffing, to optimize the performance of a rehab unit. Given the complexities of this service, program leaders need to be skilled in census development, medical staff management, staff recruitment and leadership and regulatory compliance, as well as operational and financial management. You must have an experienced leader to bring it all together.

5. Market your rehab unit internally and externally.

Maintaining optimal patient volume and case mix requires a focused, integrated and disciplined approach. This includes a team approach to internal and external referral development, as well as pre-admission screening to ensure the right patients are admitted to your program at the right time in their recovery journey.


6. Measure and track outcomes.

The ability to track and report outcomes is critical for quality improvement, referral development and positioning for reform initiatives. Do you capture and track functional improvement metrics? Are you able to compare outcomes to peer facilities? Do you measure hospital readmission rates? Can you demonstrate superior outcomes?

7. Know the regulations and comply.

Federal and state regulations, including adherence to the three-hour rule and 60/40 regulation, require constant attention and oversight. Equally important is documentation competency to ensure accuracy and to reduce denial risk. Do you have a comprehensive pre- and post-admission process to reduce denials and comply with regulations?

Medical Oversight/Staffing Issues

8. Become CARF-accredited.

CARF accreditation can help demonstrate to patients, payors and referral sources the quality of clinical care, service delivery and overall excellence of your rehabilitation services. Are you CARF-ready?

9. Choose medical directors carefully, define expectations and provide education and training.

A medical director who fully understands changing regulations and has peer support will have a positive impact on the success of your rehab unit. It is important to ensure medical directors are engaged members of the team and have the tools they need to drive program results.

10. Invest in staff education and utilize an interdisciplinary approach.

Ongoing education for managers and staff is critical for the delivery of quality care, skill enhancement and leadership development. Also important is the interdisciplinary team approach within the hospital. Program directors should serve as ambassadors to integrate nursing and therapy staff, and coordinate external resources.

The right rehab management partner can position an inpatient rehab unit for success by keeping it on track with strategies and dedicated expertise related to growth, operations, reimbursement, compliance and clinical programming and outcomes.

The Bottom Line

Inpatient rehab programs are an opportunity area for hospitals and an important component of the care continuum. Understanding the intricacies of rehab can help hospitals improve quality outcomes, their competitive advantage in the marketplace and most importantly provide an unparalleled level of patient care. Kindred Hospital Rehabilitation Services (KHRS) works with more than 150 hospital-based programs nationwide to help them bring greater success and better patient outcomes to their acute rehabilitation settings.

To learn how KHRS can help optimize the performance of your rehabilitation program, contact KHRS today.

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