Choosing a Rehabilitation Unit/CARF

Rehabilitation (rehab) services are provided in many different places, including:

• Acute care and rehab hospitals

• Subacute facilities

• Long-term care facilities

• In the home by home health agencies

• Hospitals

• Inpatient rehab centers

• Outpatient rehab centers

• Community health settings

• Private practice

• Schools

• Industrial health centers

• Veterans Affairs medical centers

• Military health care centers

Here are some general questions to ask when trying to choose rehab facilities and services:

• Does my insurance company have a preferred rehab provider that I must use to qualify for payment of services?

• What is the cost? Will my insurance company cover all or part of the cost?

• How far away is the facility? What is the family visiting policy?

• What are the admission criteria?

• What are the qualifications of the facility? Is the facility accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)?

• Is the facility well-maintained, clean, and safe?

• Has the facility handled treatment for this type of condition before?

• What are the staff's credentials?

• Is therapy scheduled every day? How many hours a day?

• Is a qualified physical therapist on staff and involved in plan of care and treatments?

• What rehab team members are available for treatment? How is the patient and family included in planning care?

• What type of patient and family education and support is available?

• Is there a healthcare provider onsite 24 hours a day?

• How are emergencies handled?

• What type of discharge planning and assistance is available?

• What can be done if care is unsatisfactory?

• Exercise is key. A rehab program should have supervised exercise training at least twice a week. This should include endurance training, interval training, resistance and strength training, upper and lower limbs, and walking exercise. Flexibility, muscle training, and neuromuscular electrical stimulation can also be included.

• Look for a customized approach. Rehab treatments should be customized for each person. This helps to achieve the best personal functional gains. A customized approach can be done in different types of rehab settings.

• Community-based and home-based programs. If the frequency and intensity of the programs are the same, community-based and home-based rehab programs are as effective as hospital-based programs.

• Programs for COPD. For people with chronic obstructive pulmonary disease (COPD), a traditional pulmonary rehab program with supervision is the most effective option. If someone with COPD is unable to go to a traditional program, then home-based exercise is an option. But it may be less effective.

• Help at home for shortness of breath. Standardized home-based pulmonary rehab programs improve shortness of breath (dyspnea) in people with COPD.

CARF stands for Commission on Accreditation of Rehabilitation Facilities. It's a private, not-for-profit organization that accredits rehab programs with some of the following services:

• Adult day services

• Assisted living

• Behavioral health services

• Medical rehab

CARF helps to promote and assure standards of quality for these programs. It focuses on optimal outcomes for people served.