Who Determines if My Loved One Needs a Residential Program?

A loved one has just been treated and stabilized by medical professionals in a hospital setting and is ready to begin the next phase of rehabilitation. This is an important time for the individual and family members because choosing the correct rehabilitation facility or program sets the tone for a successful recovery.

“Residential” is not to be confused with assisted living or a nursing home in the most traditional sense of these terms. At NeuLife, clients are not “residents.” NeuLife provides specialized rehabilitation intended to transition the client to maximum improvement, regardless of how long that takes. Some clients will stay at NeuLife for a few weeks, some a few months, and on rare occasions, a few years.

The recommendation to move an individual to a residential program comes from the treatment team. The decision of where to place the individual is made by the family. This decision can be guided by treatment team members, such as social workers, discharge planners or doctors. Financial advocates can also be helpful to identify programs that are covered by insurance or are affordable.

An individual is eligible for a residential rehabilitation treatment program if he or she meets criteria. The criteria considered are the traumatic injury prevents the individual from returning home to family care. The individual must be medically stable enough to participate in at least three hours of therapies per day. The individual is able to make progress in therapy. The individual has a family or social support system that will allow him or her to return home or to another community care setting after reasonable improvement of function. Lastly, the individual has insurance or other ways to cover the cost of treatment.

More specifically, an individual is eligible for admission to NeuLife upon meeting the following criteria:

• Is medically stable.
• Is at least 18 years old.
• Has a neurologic diagnosis including traumatic brain injury (TBI), mild traumatic brain injury (MBTI), spinal cord injury (SCI), and/or other catastrophic or challenging diagnoses including those individuals having difficulty finding a facility where specialized services, care and supervision is offered, arranged and coordinated specific to clinical needs.
• Is functioning at Ranchos Los Amigos Score of IV or above.
• Does not require 24-hour skilled nursing.
• Does not require skilled rehabilitation.
• Does not require 24-hour psychiatric care.
• Does not have Stage 3 or 4 pressure sores.
• Is free from signs and symptoms of communicable disease.
• Is able to perform Activities of Daily Living (ADLs) with supervision or assistance.
• Is able to transfer independently or with assistance.
• Must be able to be assisted with self-administered medication.
• May or may not have special dietary needs — needs will be met for an individual who has special dietary needs.
• Is not a danger to himself, herself or others.
• Is not bedridden once admitted and must not be bedridden for more than seven consecutive days following admission.
• Does not require assistance with tube feeding, oral or naso-pharyngeal, tracheotomy suctioning or monitoring blood gases.
• Does not require treatment of surgical incisions unless stabilized with a Physician’s Plan of Care and orders in place.

It is important for family members to become as informed as possible in the benefits of the programs you are considering. Below are some things to consider.

• Take time to make good decisions.
• Know your financial information. Talk with insurance carrier about your coverage. Get copies if your insurance policy or benefits plan.
• Do not rule out a facility just because it is not on the list of facilities covered by your plan. Your insurance provider may make an exception.
• Keep notes on each program.
• Compare programs.
• Do not let location be a deciding factor. Many hotels offer discounts to families who have a family member receiving care.
• Learn about staff, philosophy and outcomes at discharge.
• Visit the program.

A NeuLife staff member will often conduct an in-home or in-hospital assessment for a potential client. Sometimes an individual or family is contacted by a referral coordinator or another contact on our admissions staff. Either of these can be the first point of contact related to admission to NeuLife

NeuLife consistently provides the highest standard of care in the delivery of quality clinically relevant services to our clients with catastrophic injuries and other challenging diagnoses in order to produce superior outcomes and exceed the expectations of all persons served. Healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourages, assists and supports each one of our clients so they may achieve their specific goals.

2725 Robie Avenue
Mount Dora, Florida 32757