CARF requires 24-hour, 7-day inpatient rehab

Standards went into effect July 1

Rehab providers who seek accreditation from CARF...The Rehabilitation Accreditation Commission for their inpatient programs must show that their rehab program provides continuity in services 24 hours a day, seven days a week.

The Tucson, AZ-based accreditation commission's new standards, which went into effect July 1, require accredited comprehensive integrated inpatient rehabilitation facilities to provide coordinated and integrated medical and rehabilitation services 24 hours per day.

"Patients have less time in rehab," says Chris MacDonell, national director for the medical rehabilitation division. "This means that we need to look at programs that provide the most value for all stakeholders - the persons served, the payers, and the providers."

CARF's detailed and comprehensive new standards require providers to show that rehabilitation is a coordinated effort by an interdisciplinary team that provides continuity in services 24 hours a day, seven days a week. (For tips on ensuring your weekend coverage is in the patients' best interests, see story, p. 137.)

"This means that the same transfer technique that is used at 2 p.m. on Friday is carried out at 7 a.m. on Sunday and at 2 a.m. on Tuesday," MacDonell says.

The new standards require providers to come up with new ways of communicating and exchanging information among everyone who provides patient care, no matter when they work or what their job is, she says. "Everybody on the team, no matter who they are, contributes to the success of the person served. With the very short lengths of stay we're seeing today, we have to be sure we are putting together a program that is integrated and comprehensive." For instance, if a patient starts to use new adaptive equipment or needs to work on a particular activity of daily living, such a toileting transfers, the entire treatment team must do it the same way.

There's no one way to do this, she says. "We expect each program to develop its own approach. But our surveyors are going to be looking for ways that everyone who works with the patient communicates with each other."

[For more on CARF, call (520) 325-1044 or visit the Web at]