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Understanding Healthcare

Choosing a Rehabilitation Unit/CARF

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Choosing a rehab facility

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?


Important points about rehab programs

  • 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.


What is CARF?

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.

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