There must be reasonable expectations for enhancing the patient's level of functioning. Each patient is evaluated and treated by a team of professionals assisted by family members. The team is led by a physician specializing in physical medicine. Evaluations for functional deficits in physical, psychological, social, vocational, and cognitive areas are completed at the time of admission. Weekly conferences are held with the team to measure progress and modify treatment plans.
All progress is reported to family members, referring physicians, and referring facilities.
As the patient reaches goals, case managers confirm discharge plans made prior to the patient's admission and how these plans meet the needs of patients and family members. After leaving the inpatient setting, support for ongoing outpatient care is made to continue the patient's recovery process.