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Responding to Patient’s Needs for Subacute Rehabilitation during a Pandemic

*** CCM Ethics, RN and SW hours ***
Originally presented at 2021 Annual Conference

The COVID-19 pandemic of 2020 created multiple crises in healthcare; access to sub-acute rehabilitation services for COVID + patients, capacity issues for acute care facilities, need to protect current residents/patients in sub-acute facilities. In short, monumental throughput issues impacting the ability of the healthcare continuum to keep up with the flow of admissions and discharges and potentially ethical issues in access to services and levels of care related to a diagnosis. With the finite number of resources (hospital beds, rehabilitation beds, staff) and the ever-increasing patient population experienced during the pandemic, the ability to move patients effectively and efficiently through the continuum gained more focus than ever. Waivers of all types were implemented from the federal levels to address this potential threat to healthcare. However, being faced with an unprecedented, unknown public health issue demonstrated the dichotomy in the healthcare continuum: the need for the acute side to “keep moving” to treat the never-ending flow of admissions and the need for the sub-acute side to protect their patients/residents who may not be “moving” through the continuum at the same pace. This presentation will review the impact of the COVID-19 pandemic on acute, subacute care continuum, explain the use of the 1135 waivers, discuss the potential ethical implications of COVID-19 on the healthcare continuum and review one hospital’s response to this issue and the impact one facility can have the larger healthcare community.

OBJECTIVES: 
  1. Explore the impact of COVID-19 on Throughput across the Continuum of Care for COVID-19+ patients.
  2. Discuss the concept of “medical discrimination” and ethical considerations of care of COVID-19+ patients related to post acute service availability.
  3. Review the implementation of the COVID-19+ Sub Acute Rehabilitation unit from conception through execution as well as outcomes and case study review.