Trial Admission Program (TAP)

Sometimes a person may benefit from rehabilitation even if he or she has not been in the hospital due to illness or surgery.   Since RHCI is a hospital, Medicare allows  patients to be admitted to RHCI from home or from the Emergency Room without a prior three-day hospital stay.

The Trial Admission Program (TAP) assists persons living in the community who have had a recent, significant loss of function due to a known condition or well-defined diagnosis.  Persons who may qualify for admission to TAP include those with:  

• Parkinson’s disease and/or movement disorder 
• Recent stroke with functional decline
• Gait disorders due to a known cause
• Recurrent falls due to a known cause
• Multiple sclerosis exacerbation (flare-up) with loss of function
• Brain or spinal cord injury with a need for specific skill training
• Post-polio syndrome
• Spasticity
• Other diagnoses considered on a case-by-case basis

The goals of TAP are: 

• To assess the unique needs of the individual 
• To make recommendations for treatment or change to promote the individual's highest level of functional independence.

Admission to TAP
A person may be referred to TAP by a primary care physician, home health agency, emergency room or skilled nursing facility. The person (or a family member) may also refer him or herself to the program, as long as the primary physician is in agreement. One of our Referral Nurses will interview the individual and/or family to determine eligibility for the program.

In some cases, a patient may need to see an RHCI physician prior to admission to TAP.  The RHCI physician will determine if the person will likely benefit from admission to TAP. 

Patients are generally admitted to TAP on Monday and the meeting with family is held at the end of the week. 

Recommendations and Family Meeting

During the patient's four-day inpatient stay, the RHCI team conducts a comprehensive assessment to determine his or her potential for rehabilitation.  The assessment of the patient's functional, medical and behavioral needs concludes with specific recommendations for the appropriate level of care and setting.  Family members must be available to meet with RHCI staff at the end of the assessment, usually day four. 

Possible recommendations include:

• Inpatient rehabilitation (the patient may continue at RHCI)
• Outpatient rehabilitation
• Home care
• New equipment
• Transfer to a long-term care or skilled nursing facility

If the patient does not meet the criteria for inpatient rehabilitation at RHCI, an RHCI case manager will facilitate discharge at the end of the assessment.  In all cases, RHCI will communicate the results of the assessment  to the referring physician. 

TAP  Eligibility Criteria

• Patient meets Medicare criteria for medical necessity
• Decline in function is related to a known condition or diagnosis
• Patient is motivated to participate
• Payment is available for program
• Community physician is in agreement with the referral

For more information about TAP, please call Admissions:  (508) 833–4200

Additional Information for Physicians, Home Care Agencies and other Referral Sources

Before a patient may be admitted to TAP,  the referring physician or agency must provide adequate documentation, including:  

• The patient's History and Physical or other recent documentation indicating patient status
• Demographic information, including insurance information
• List of prescribed medications
• Current assessment of the patient's functional status (home care agency documentation or outpatient therapy assessments)
• Documentation that the patient is able and willing to participate in the program

Note:  Some referred patients may be required to be seen by an RHCI physician prior to admission to determine if they are appropriate candidates for TAP.

Factors That May Prevent Admission

• Functional independence
• Non weight-bearing status
• Moderate to severe dementia
• Chronically bedridden

For more information, please call Admissions at (508) 833-4200.