Question

Joe is a Medicare beneficiary who has been in the acute care hospital for 4 days following surgery for a hip fracture. He is a widower, lives alone, and his children live out of the state and are unable to assist. Functionally he is at a moderate to maximal assist level. He will need to be independent in order to return home. Endurance for therapy is low (1-2 hours/day) due to pain and fatigue. Given these circumstances what would be the appropriate discharge recommendation?

1) Home health
2) IP Rehab
3) Outpatient therapy
4) Sub-acute SNF

Answer 1

An Inpatient Rehabilitation (IP Rehab) facility would be the most appropriate discharge recommendation for Joe, given his need for intense rehabilitation, medical supervision, and lack of family support to manage post-surgery risks.

Step-by-step explanation:

Given Joe's medical condition and current functional limitations, he will require a structured rehabilitation program to regain independence. Considering his low endurance for therapy, high level of assistance needed, and lack of family support, an Inpatient Rehabilitation (IP Rehab) facility would provide the intensive multidisciplinary care necessary for his recovery. Here, he can receive a concentrated rehabilitation program within a medical environment designed to manage his pain and fatigue. This setting is more appropriate than sub-acute skilled nursing facility (SNF), outpatient therapy, or home health, as they may not offer the same intensity of rehabilitation services or medical management required in Joe's case. He'll be under the supervision of specialists who can also monitor for complications like blood clots, pneumonia, pressure sores, and infections that are risks following hip surgery.