Choosing a Rehabilitation Unit/CARF

Rehabilitation (rehab) services are provided in many different places. These include:

• 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 practices.
• 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 get 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 members' credentials?
• Is therapy scheduled every day? How many hours a day?
• Is a qualified physical therapist on staff? Are they involved in plan of care and treatments?
• What rehab team members will help with 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 doctor at the facility 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 isn't able 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, nonprofit organization that accredits rehab programs. The programs offer services such as:

• 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.