In post-hospital care, words can be confusing. And no word is more important to understand than 'rehabilitation'.
Many facilities—from nursing homes to outpatient clinics—say they offer 'rehab'. But the quality, intensity, and medical oversight can vary dramatically. This isn't just a small difference; it's the difference between a slower-paced recovery and an intensive, hospital-level program designed to get you home.
So, how can you be sure you're choosing a true, certified Inpatient Rehabilitation Facility (IRF)? You have to ask the right questions. This guide provides a simple 5-point checklist to help you identify the highest standard of rehabilitative care.
Why the "IRF" Designation Matters
Before we get to the questions, it's important to understand that "IRF" isn't just a marketing term. It's an official designation from the Centers for Medicare & Medicaid Services (CMS). An IRF is a special type of hospital, and to receive this designation, a facility must prove it provides a hospital-level of intensive, coordinated, and physician-led rehabilitative care.
This matters because this model is proven to help patients recover faster, regain more function, and have a higher likelihood of returning home.
The Comprehensive 5-Point Checklist
Use these five direct questions when speaking to a hospital case manager or a facility's admissions coordinator. The answers will tell you everything you need to know.
1. The Therapy Question: "How many hours of therapy will my loved one get each day?"
- The IRF Answer: "A minimum of three hours per day, at least five days a week." This is the non-negotiable "3-Hour Rule" for IRFs. This intensive schedule involves a combination of physical, occupational, and/or speech therapy.
- Red Flag: A vague answer like, "As much as they can tolerate," or, "We offer therapy a few times a week." This signals a less intensive, nursing-home level of rehab.
2. The Doctor Question: "How often will a doctor see them?"
- The IRF Answer: "A specialized rehabilitation physician, known as a physiatrist, will oversee their care and sees patients at least 3x/week and are available 24/7 as needed." This daily medical oversight is critical for managing complex conditions and adjusting the care plan in real-time.
- Red Flag: "A doctor is on call," or, "The doctor rounds once or twice a week."
3. The Team Question: "Who exactly will be on the care team?"
- The IRF Answer: "A dedicated, interdisciplinary team." This should include the physiatrist, rehabilitation nurses (not just standard nurses), physical and occupational therapists, speech-language pathologists, a clinical care coordinator, and often a psychologist. A true IRF team meets regularly for patient care conferences.
- Red Flag: A list that is primarily nursing staff with access to outside therapists.
4. The Outcomes Question: "What percentage of your patients go home after their stay?"
- The IRF Answer: A true IRF is proud of its outcomes and tracks this data closely. They should be able to give you a specific number. For example, top-tier IRFs consistently discharge about 80% of their patients directly back into the community.
- Red Flag: "We don't really track that," or an inability to provide any data on patient outcomes.
5. The Official Status Question: "Are you a CMS-certified Inpatient Rehabilitation Facility?"
- The IRF Answer: "Yes." It's a simple, direct question. Any hesitation or attempt to redefine the term is a major red flag.
- Red Flag: "We have a rehab unit," "We are like an IRF," or any answer other than a clear "yes."
Quick Checklist Guide: The 5 Must-Ask Questions
Here is a quick "cheat sheet" you can use when making calls. If the answer to any of these is "no" or seems vague, you are likely not speaking with a true IRF.
✅ Therapy: Will they get at least 3 hours per day?
✅ Doctors: Will a rehab physician see them 3x/week with daily oversight?
✅ Team: Is there a full interdisciplinary team?
✅ Outcomes: Can you share your return-to-home rate?
✅ Status: Are you a CMS-certified IRF?
What to Look For During a Facility Tour
If you have the chance to tour a facility, keep an eye out for these signs of a true IRF:
- A Large, Active Therapy Gym: You should see a dedicated, spacious gym with advanced equipment and multiple patients working actively with therapists. The atmosphere should be focused on rehabilitation.
- Adaptive Living Spaces: Look for model environments that simulate real-life situations, such as a mock kitchen, bathroom, or bedroom. These areas allow patients to practice daily living skills in a safe and controlled setting.
- Patient Lifting Technology: Modern IRFs often utilize ceiling-mounted or portable patient lift systems. This technology assists staff in safely transferring patients with mobility challenges, reducing the risk of injury.
- Team Collaboration Areas: Observe if there are dedicated spaces where the interdisciplinary team can meet and discuss patient progress. This indicates a commitment to coordinated care.
A Patient’s Experience: The Difference an IRF Makes
This checklist is your guide, but what does this level of care feel like for a patient's family?
“The level of care that REHAB provided me as an inpatient up on the fourth floor was amazing… all the CNAs and therapists, the people who helped me get ready to start the day and end the day, they treated me with the utmost care and dignity. This was the hardest thing I’ve had to do, but their kindness and compassion was huge in my recovery. They helped me get my life back.” - Deborah Kobayakawa, Stroke Survivor
This experience highlights the key elements of a true IRF in action: daily physician oversight and a dedicated team of expert therapists working together to push a patient toward their best possible outcome. This is the level of care that helps rebuild lives.
The REHAB Hospital of the Pacific Standard
At REHAB Hospital of the Pacific, the answers are clear. We are Hawaii's only licensed and certified Inpatient Rehabilitation Facility.
- We provide a minimum of 3 hours of therapy per day.
- Our patients are seen daily by a specialized physiatrist.
- Our care is delivered by a dedicated, interdisciplinary team of experts.
- We proudly send 83.2% of our patients back home to their communities.
When you're making this critical decision, don't settle for "rehab-like." Demand a true IRF. Our admissions team is ready to answer all these questions and more.