I knew I was going to a rehab place so I did what many suggested. First, get a list of approved places from your insurance company. Also, find out all their requirements for precertification and how many days they will pay for. I have Blue Cross of Alabama and for a BTKR they will pay for 7 days. I had problems and was there for 10 days and the rehab center applied for review etc but they rejected the extra 3 days. In the end they did pay for them. Alot will depend on how the doctor and staff write things up.
There are only 3 approved rehab facilities in the state plus 1 in the neighboring state and all of them are inpatient units of a hospital. I did visit 2 of them which I thought would be the most likely place. The first one seemed to do mainly stroke and brain injuries and seemed geared to older people. The second one did alot of orthopedics as they are close to the state ski areas and the local orthopedic group is very well known. The 3rd one was at the academic medical center was bigger 40 beds vs 10-12 at the other places but I found academic facilities not to my likening. I also factored in if I would have to be transferred there from the hospital I had the surgery at. That would have meant a 1 1/2 to 3 1/2 hour ambulance ride.
I found the second one which did alot of orthopedics seemed the best place, it was well staffed with PT, OT, and if you needed it speech therapy. Also because it was a specialized unit, the nurses were all experienced in rehabilitation. I also like the fact they use a team approach so there is a physical medicine doctor who works will a set group of therapists so things were very smooth. Also, the nurses are part of the team and they carry on with what the PT's wanted. For me, it was being reminded to bend my knees. Anytime I was out walking, someone would remind me.
I also changed my mind at the last moment and canceled surgery with the OS and went with a different one who practiced at the hospital with the rehab unit so I just had an elevator ride upstairs.
Nursing homes and skilled nursing facilities can be tricky. Some actually have acute rehab sections while the others are regular nursing homes. I would avoid any place that did not have acute rehab services.
Make an appointment to visit the place. Look around and see if people were just lying in bed or were up and involved. is there enough staff, i.e. are bells going off and not being answered. Ask what a typical day looks like, were I was each patient had a white board on the wall with the days scheduled on it so you knew where you should be and nursing could schedule things to avoid therapy time. Do people eat their meals in bed/room or is there a central dining room. Is there a case manager to coordinate care as well as after care (transportation home, home health care, doctor follow visits, meds). Are family members asked to participate in the planning, therapy and invited to meetings? If you have special food needs like vegetarian can they handle it. Where I was they said, I could bring in meals and keep them in the freezer. I would have done that if the hospital was not 3 hours from home. Are there facilities to wash clothes if you dont have someone that can bring you things. For me, doing the wash was part of therapy. Do they have the type of bath/shower you use at home so that you can practice on that? Do they have a little kitchen to practice on.
Ask the physical therapists about their background and what they specialize in? Ask how many knees have they done. Ask what there treatment philosophy is very aggressive, aggressive but geared to the patient, or take it easy view (bad idea).
Do they do a home assessment? I was too far from home but if I was closer, they would have checked out the house and made sure it was safe (no throw rugs, cords out of the way) as well as taking an inventory to see what you need like a shower chair, toilet high rise seat etc. They had me call someone to measure the shower area, how much room was free around the toilet etc. I live alone so this was more important. They also check out things like stairs and outside surfaces. I have a gravel driveway so they covered that in PT because the uneven surface can throw you off.
When you walk around you will get a feeling about the place.
Also, while you are at it, checked out the outpatient PT you will be using. I found a smaller practice is better as you will get more 1 on 1. Many large places like hospital outpatient you will get whoever is there.
Hope this helps.
Simon
United States
