Critical shortage of rehab beds highlights a strained system, impact on patient safety

Editor's Note

A critical lack of beds in rehabilitation facilities and postdischarge care is impacting patient recovery postoperatively, Forbes December 12 reports. According to the article, procedures involving brain and spinal cord injuries are the most impacted.

Authors Robert Glatter, MD, an emergency physician at Lenox Hill Hospital in New York City, and Peter Papadakos, MD, professor of anesthesia and critical care at the University of Rochester Medical Center, write that the lack of available rehab facilities has become a major crisis in the last several years. Following are some highlights from their comments, per Forbes:

• The pandemic “significantly buttressed the economic health” of rehab facilities, forcing them to downsize or close.
• Thanks to significant advances in neurocritical care medicine, more people are surviving traumatic injuries, but there’s a lack of needed inpatient physical and behavioral health services at specialized rehab centers necessary for them to live independently with their injuries.
• When rehab center beds are not available, these patients must stay at the hospital and become a strain on resources, particularly in emergency departments. 
• The staffing crisis has spawned a year-long study aiming to propose new mandatory minimum staffing standards for long-term care facilities; however, this might “actually add to the problem in the short term as a result of a reduced pool of qualified health workers, specifically…RNs as well as certified nursing assistants (CNAs).”
• The bottleneck can also prevent ORs from operating at full capacity, which greatly impacts a hospital’s bottom line.

“The result is, all patients wait longer and ultimately suffer worse outcomes,” said Jesse Pines, MD, MBA, MSCE, chief of clinical innovation at US Acute Care Solutions, a physician-owned provider of acute care hospital management. The authors write that leaders in healthcare and government must move quickly to address this crisis, which is greatly impacting patient recovery and the quality of the US healthcare system.