Appendix III: Inpatient spinal cord injury rehabilitation

Having a new spinal cord injury (SCI)

Most people with a new SCI will need inpatient rehabilitation to gain independence and learn new ways to do things. After talking with your doctors, your social worker will talk with you and your family about your choices for centers.

It is best if you can help make the final decision on which rehabilitation center is right for you. Family can tour rehabilitation centers to ask the questions below, and to get a feel for the center and whether or not it may be a good fit for you. If your family is not able to tour the center(s), they may want to ask a friend or other family to visit and share what they see.

The social worker helping with discharge planning also has videotapes about many centers. Talk with the social worker if you would like to have video equipment set up in your room so you can see the centers.

What to think about when choosing a rehabilitation center

Rehabilitation center’s experience with SCIs

  • How many people with SCIs have they treated in the last year?
  • What is the average number of people at the center at any one time?
  • What is the average number of people with an SCI at any one time?
  • What is the average length of stay?
  • What kind of treatment outcomes can the center provide for people with an SCI?

Staffing to handle spinal cord injury rehabilitation

  • How many years of experience do key staff have?
  • What is the patient-to-nurse ratio?
  • What is the patient-to-therapist ratio?
  • Are the following team members full-time staff or consultants?
    • Physical therapist
    • Occupational therapist
    • Physiatrist (a doctor who specializes in rehabilitation and physical medicine who will be overseeing the entire rehabilitation hospitalization). Are they board-certified in SCI medicine?

Therapy plans for spinal cord injury rehabilitation

  • How often do physical and occupational therapists see people (1 or 2 times a day, on weekends)?
  • Who does evaluations and makes recommendations if a person needs a specialized wheelchair or equipment?
  • What does the vocational (return to work) program consist of at their center?

Rehabilitation center's emergency plan

  • Is there a doctor on site 24 hours a day in case of an emergency, such as breathing problems, infections, or falls?
  • Are patients referred to a nearby hospital for medical emergencies?

Environment for spinal cord injury rehabilitation

  • Is there enough physical space for therapy?
  • Is the center clean?
  • Is there a positive atmosphere?
  • Are staff attentive and positive toward the people they are working with?
  • Is there a daily schedule posted noting the time and place each person should be throughout the day?
  • After touring all the centers, what is your overall feeling? Sometimes instincts are as valuable as concrete facts.

Rehabilitation center family involvement

  • How far is the center from your home?
  • If it is a long distance, it may limit visits from friends and family. How will that affect the progress of your loved one?
  • How often are family meetings scheduled?
    • Routinely scheduled at specific intervals?
    • When progress is made?
    • When no progress is made?
    • Emergency changes?
  • What is the policy on home visits?
  • Are there any educational or support groups for family members at the center?

Discharge plans for spinal cord injury rehabilitation

  • At what point is a person ready to leave the center?
  • How does the center help to plan for discharge?
  • Is there post-discharge follow-up?
  • Will the center help you get equipment, such as wheelchairs, to go home with?
  • Do they do home evaluations to give accessibility recommendations?

Financial questions for rehabilitation centers

  • Does your insurance company have "in-network" providers that are covered better?
  • After you are at a chosen center, who is responsible for communicating with the financial/insurance provider? How often?
  • How long will insurance last (both in months and dollar amounts)?
  • What other costs may there be?
Last reviewed: 
March 2018

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