POLICIES AND PROCEDURES  

Admission, Continuing Stay, and Discharge/Transition Criteria for Persons Served in the Occupational Rehabilitation Program

SAINT ALPHONSUS REHABILITATION SERVICES
Rehabilitation Management Associates, Inc. (RMA)

POLICY PURPOSE: To document and define the Admission, Continuing Stay and Discharge/Transition Criteria for the Occupational Rehabilitation Program (ORP) at St. Alphonsus Rehabilitation Services (STARS).

Responsible Personnel:  Clinical Operations Manager, Manager of Rehab Quality & Compliance, and ORP Team.

Admission Criteria:  The criteria for admission to the ORP Program at STARS, an outpatient service, are as follows:

  • The client must have a work-related injury that requires interventions to address physical impairments, activity limitations, work capacities, and participation restrictions with the goal of safe return to work.
  • The client has not reached his or her potential for independence in mobility, and work capacities for vocational activities.
  • The client must be medically stable and of a medical acuity that allows full participation in an intensive rehabilitation program.  
  • Services must be reasonable and necessary. Services must require the experience and expertise of a skilled therapist/provider.   
  • The client’s condition must indicate a potential for improvement in functional and work capacities in a reasonable period of time.  
  • Medical comorbidities/complexities must not affect the client’s ability to participate and benefit from therapy or put others at risk (e.g., infectious disease process).
  • Psychological/behavioral status must not place other clients or staff at risk or hinder ability to benefit from the program.
  • The ORP Program accepts adult clients18 years old and higher. 

Continuing Stay Criteria

Each of the following conditions must be met in order to justify continuation of services:

  • The client is able to tolerate and participate actively in therapy.
  • The client must make significant, objective, progress or demonstrate the potential to make change in functional and work capacities that moves the client towards to goal of safe return to work.  
  • Continuous progress has been demonstrated and documented in the clinical notes.
  • The client’s condition and treatment plan continues to require the experience and expertise of a skilled therapist.
  • Services continue to be reasonable and necessary.
  • The client must demonstrate good feasibility characteristics in the areas of productivity, safety, and interpersonal behaviors.


Discharge/Transition Criteria

Release/discharge from the ORP Program will occur when:

  • The client has achieved the goals that he or she established with the rehabilitation treatment team.
  • Multi-disciplinary therapy is no longer needed.  Discharge from single discipline therapy will be considered when the services of skilled therapists are no longer necessary.  
  • Additional change in functional &/or work capacities cannot be anticipated.
  • The client’s progress has slowed or temporarily stopped and he or she is no longer benefiting from the services of the program.
  • The presence of medical, psychological, or social problems hinder the client’s ability to participate.
  • The rehabilitation program is “put on hold” due to prosthetic fittings, resolution of medical problems, pending surgical intervention, or the arrival of specialized equipment.
  • It is the psychiatrist’s conclusion and/or the team’s consensus that other programs or levels of care and treatment are indicated and more appropriate for the client.
  • The client requests discharge (even against medical advice assuming legal competence).
  • The client is non-compliant, does not adhere to feasibility agreement and/or behavioral contracts, engages in drug or alcohol abuse, or causes safety concerns for staff or others.