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Decline in Rehab Care: Where Are The Patients Now?


Skilled Nursing Facilities, also known as Nursing Homes, used to be busy with medical staff and patients being seen after surgical and medical procedures. The Covid-19 pandemic has taken away the availability of care, attention and focus on recovery for many people.

Daily, intensive rehab services provided by physical, occupational, speech and respiratory therapists are a thing of the past. Nursing collaboration with doctors on staff and supportive social services to address the social needs of seniors have faded away. The conversations over activities and meals where comradery and community feel for individuals recovering from illness or surgery are now silent. Where are the patients now?


The Covid-19 pandemic along with changes in reimbursement from Medicare through the Patient Driven Payment Model (PDPM) have redistributed the allocation of money and services to transition from hospital to home. The decline in rehab care was inevitable with cases of fraud and rising costs of Skilled Nursing Facilities. Skilled Nursing Facilities have transitioned back to nursing homes where the focus is on maintenance of care versus improvement.


Patients are now found in the home. Home health nursing and therapy services are being provided but singularly rather than collaboratively. The addition of video calls for doctor visits when technology and caregiver services are available. Social services being provided by the county and meals either made alone or through meals on wheels. This new model can provide comfort to the clients within their homes, yet the community feel is lacking. It runs under the assumption that family and income can offset the levels of needs necessary for each person recovering from surgery or illness.

Empty chairs and empty tables where the healthcare professional and patients used to thrive. Covid 19 pandemic and PDPM have impacted rehab care and health care services as the Boomer Generation ages. Where does the American Healthcare System go from here?


Janet Dee, PT 9/14/22

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