Disclosures: Anandeep kumar, MD: No financial relationships or conflicts of interest

Objective: Hospital inpatient disposition barriers to acute inpatient rehabilitation facility (IRF) IPR programs.

Design: Various Third party payors and their contracted agencies are imposing unnecessary barriers indirectly obstructing seamless transfer and disposition of patients in the post acute care continuum from acute care hospital setting to acute inpatient rehabilitation IRF/IPR programs. We analyzed data for several years obtained from the medical records to quantify the magnitude of this problem.Setting : Acute care hospital setting Participants : Sabrina Dieffenbach, Barent Bradt, Abdullah Adnan, Anandeep Kumar, MD, FAAPMR

Interventions: We analyzed several years of hospital data, evaluations by the Rehabilitation teams and physiatry consultation recommendations in order to identify the magnitude of this problem and to come up with possible resolutions to these barriers causing delays and denials of appropriate rehabilitative care. Overall in 2020, 476 out of 845 patients (56.33%) were recommend to IPR; 208 out of 476 patients recommended (43.70%) actually got discharged to IPR.

Main Outcome Measures: Data analysis indicates 43.70% of IPR appropriate patients were actually admitted to IPR. IPR disposition is a multifactorial complex process requiring teamwork optimization and streamlining of hospital workflow. Critical to accurately identify and quantify various disposition barriers to the next appropriate level of care interventions.

Results: Data analysis indicates 43.70% of IPR appropriate patients actually were admitted to IPR.Conclusions: Patients with residual functional impairments meeting all medical necessity criteria for IPR IRF are not getting successfully Approved/Authorized admitted/discharged despite clinical documentation by multidisciplinary teams and despite Physiatrist’s strong advocacy efforts, a challenging area that warrants further research and larger clinical community discussion.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/hospital-inpatient-disposition-barriers-to-acute-inpatient-rehabilitation-facility-irf-ipr-programs/