Direct Admission Program

Sometimes a person may benefit from rehabilitation even if he or she has not been in the hospital due to illness, injury 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 hospital stay.

The Direct Admission Program (DAP) assists persons living in the community who have had a recent, significant loss of function due to a known condition or well-defined diagnosis.  The goal of the Direct Admission Program is to improve the person's functional abilities by providing direct access to intensive, multi-disciplinary inpatient rehabilitation. 

Qualifying Conditions for RHCI's Direct Admission Program include:   

• 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

Admission to RHCI's Direct Admission Program
A person may be referred to DAP 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 DAP.  The RHCI physician will determine if the person will likely benefit from direct admission to RHCI. 

Direct Admission Program  Criteria

• Patient meets Medicare criteria for medical necessity, which includes:
  • Needs to be seen by a physician at least 3 times per week
  • Requires, and is able to participate in, about 3 hours of therapy per day for at least 5 days per week
  • Is expected to make measurable improvement in functional capacity or adapting to impairment that is of practical value
• 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
• Patient is 15 or older

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

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

Before a patient may be directly admitted to RHCI,  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:  An RHCI physician may need to evaluate some referred patients prior to admission to determine if they meet the criteria for direct admission to RHCI.  

Fators 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.