It is estimated that at least 700,000 COVID-19 survivors will require post-acute care after hospital discharge. Individuals that survive critical COVID-19 illness are facing serious impairments. They may have profound weakness, deconditioning, delirium, postural instability, decreased lung capacity and significant functional deficits. These individuals require rehabilitation in a post-acute setting to improve functional status prior to returning back to normal life.
Are you ready and willing to care for these patients?
As the COVID-19 pandemic continues to evolve, the nation is starting to focus more on the post-acute needs of COVID-19 survivors. While most people have mild symptoms, patients with severe COVID-19 cases often require intensive care and face serious complications such as acute respiratory distress syndrome, acute liver injury, acute cardiac injury, acute kidney injury, and septic shock. Hospitals across the country have risen to the challenge of caring for critically ill COVID-19 patients, but the care needs of patients extend beyond the walls of the hospital.
Recognizing that rehabilitation services are vital, many post-acute providers have customized adaptations in response to the unique needs of COVID-19 patients. For example, skilled nursing facilities have dedicated special recovery units; and Senior Living communities are making accommodations to allow for home health and outpatient services.
By admitting recovered COVID-19 patients for rehabilitation, not only are these progressive practices fulfilling an urgent need, but post-acute providers are also strengthening partnerships with upstream providers and improving their census.
Therapy is a critical component of the rehabilitation process for patients recovering from a critical illness and COVID-19 is no exception! Well-trained therapy teams can expertly work to improve function, respiratory status and safety while developing a comprehensive discharge plan to reduce risk of readmission to the hospital. Therapy for COVID-19 patients should include:
- An individualized approach that factors in functional impairments, cognition, caregiver support and the next level of care
- Careful monitoring of vital signs and lung sounds
- Respiratory rehabilitation
- Mobility and functional rehabilitation
- Health literacy and training on infection control practices
- Virtual home assessments and caregiver training
Some HealthPRO Heritage partners were among the first in the county to care for COVID-19 patients. By sharing some of their best practices, other providers may learn from their success:
- Develop an overall plan that includes admission criteria, dedicated units, dedicated staff and infection control policies to keep patient/resident population and staff safe. (HealthPRO Heritage’s team of Infection Preventionists have developed an “Infection Control Toolkit” to assist with this clinical imperative, and have made this invaluable resource complimentary to all post-acute care providers in the industry.)
- Proactive sourcing of PPE! Leverage connections with upstream providers and network partners to get PPE.
- Staff training to ensure appropriate clinical care and infection control. For example, HealthPRO Heritage rehabilitation professionals have received special COVID-19 training and have passed written competencies to ensure clinical success.)
- Leverage technology. Consider physician assessments via telehealth. Telehealth and remote monitoring can be provided in home health as an adjunct to in person visits.
- Discharge planning. As the need for COVID-19 rehabilitation continues to grow, patients may need to be discharged faster to make room for new patients. A strong, proactive discharge process is necessary for this to occur. (For example, HealthPRO Heritage’s proprietary Safe Transitions Framework identifies and addresses obstacles standing in the way of a safe, efficient transition to the next level of care.)
- Partner with a therapy provider that supports, values and invests in therapy professionals who are ready and willing to step up and provide essential rehabilitation services to COVID-19 survivors!
Grabowski DC, Joynt Maddox KE. Postacute Care Preparedness for COVID-19: Thinking Ahead. JAMA. Published online March 25, 2020. doi:10.1001/jama.2020.4686
Lindenauer PK, Stefan MS, Pekow PS, et al. Association Between Initiation of Pulmonary Rehabilitation After Hospitalization for COPD and 1-Year Survival Among Medicare Beneficiaries. JAMA. 2020;323(18):1813–1823. doi:10.1001/jama.2020.4437
Sheehy LM. Considerations for Postacute Rehabilitation for Survivors of COVID-19. JMIR Public Health Surveill 2020;6(2):e19462. URL: https://publichealth.jmir.org/2020/2/e19462. doiI: 10.2196/19462
Wainwright TW, Low M. Letter to the Editor, Beyond Acute Care: Why Collaborative Self-Management Should be an Essential Part of Rehabilitation Pathways for COVID-19 Patients. J Rehabil Med. 2020; 52: jrm0000X
Simpson, Robert PhD MBChB; Robinson, Larry MD Rehabilitation following critical illness in people with COVID-19 infection, American Journal of Physical Medicine & Rehabilitation: April 10, 2020 - Volume Publish Ahead of Print - Issue - doi: 10.1097/PHM.0000000000001443