Because many patients are unable to return directly home from the hospital after suffering a serious injury or illness, inpatient rehabilitation hospitals such as ours provide the essential therapies and care that these patients need to gain the independence and strength required to return to their pre-event state.
In 2002, the Centers for Medicare and Medicaid Services (CMS) began implementation of what is known as the 75 Percent Rule for inpatient rehabilitation hospitals.
This meant that a percentage of patients, increasing during the next few years to as much as 75 percent, must be treated for one of 13 specific conditions for a hospital to retain its inpatient rehabilitation status. Maintaining our credentials as an inpatient rehabilitation hospital is crucial to our community and the people we serve as we are the only rehab hospital in Southeast Texas.
Essentially, the 75 Percent Rule does not take into consideration the conditions of certain classes of patients -- including cardiac patients, orthopedic patients, patients with generalized de-conditioning, transplant patients and many others whose conditions might not appear within the 13 diagnosis guidelines, but who desperately need intensive rehabilitation to get back to their previous level of independent function.
Instead, these patients are forced to either discharge home and receive little to no therapy, or they are discharged from the hospital to a skilled nursing facility where the therapy they receive is significantly less intensive compared to inpatient rehabilitation.
While I agree that there is a need for skilled nursing units, many patients are being placed within these facilities simply because there is no other option due to the limitations set forth by this rule.
Like me, other hospital administrators across the nation are feeling the pressure of operating under a rule that decreases the number of patients desperately in need of care that we can treat but do not fall within a specific category of care. We are worried that this rule, scheduled to reach 75 percent in 2008, will diminish our ability to provide quality inpatient rehabilitation care to the people who need it most.
Due to these concerns, bipartisan legislation has been introduced by members of the U.S. House of Representatives and the U.S. Senate to prevent full implementation of this burdensome federal regulation. These members of Congress introduced the "Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007," which addresses the concerns of the entire inpatient rehabilitative health care community.
The bill would hold the threshold of compliance at 60 percent, which is the current level, thus allowing some patients whose medical conditions are not listed within the 13 diagnoses criteria a better chance of receiving inpatient rehabilitative care.
As the administrator of the only free standing inpatient rehabilitation hospital in Southeast Texas, I do not want to face the difficult dilemma of being forced to tell patients that we cannot provide the care that they need. It is my belief that the "Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2007" is the best solution presented so far by which those of us in the inpatient rehabilitation health care community can provide the best available care.
For years, doctors have been empowered under Medicare to prescribe these services for senior adults, people with disabilities, and others who need them. This longstanding policy of letting physician decide what is best for their patients is changing dramatically, potentially causing harm, unless Congress takes action immediately by joining their fellow colleagues in support of the proposed legislation.
Let's hope they act soon!
To see more of The Beaumont Enterprise, or to subscribe to the newspaper, go to http://www.www.beaumontenterprise.com/. Copyright (c) 2007, The Beaumont Enterprise, Texas Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
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