Rehabilitation Providers Research Articles

Motor Dysfunction in REM Sleep Behavior Disorder: A Rehabilitation Framework for Prodromal Synucleinopathy

Parkinson disease (PD) and other related diseases with α-synuclein pathology are associated with a long prodromal or preclinical stage of disease. Predictive models based on diagnosis of idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) make it possible to identify people in the prodromal stage of synucleinopathy who have a high probability of future disease and provide an opportunity to implement neuroprotective therapies. However, rehabilitation providers may be unaware of iRBD and the motor abnormalities that indicate early motor system dysfunction related to α-synuclein pathology. Furthermore, there is no existing rehabilitation framework to guide early interventions for people with iRBD. The purpose of this work is to (1) review extrapyramidal signs of motor system dysfunction in people with iRBD and (2) propose a framework for early protective or preventive therapies in prodromal synucleinopathy using iRBD as a predictive marker. Longitudinal and cross-sectional studies indicate that the earliest emerging motor deficits in iRBD are bradykinesia, deficits performing activities of daily living, and abnormalities in speech, gait, and posture. These deficits may emerge up to 12 years before a diagnosis of synucleinopathy. The proposed rehabilitation framework for iRBD includes early exercise-based interventions of aerobic exercise, progressive resistance training, and multimodal exercise with rehabilitation consultations to address exercise prescription, progression, and monitoring. This rehabilitation framework may be used to implement neuroprotective, multidisciplinary, and proactive clinical care in people with a high likelihood of conversion to PD, dementia with Lewy bodies, or multiple systems atrophy.

Exploring Race Differences in Satisfaction With Rehabilitation Following Total Knee Arthroplasty: A Qualitative Study.

The purpose of this qualitative focus group study was to explore race differences in the rehabilitation experience and satisfaction with rehabilitation following total knee arthroplasty (TKA). We conducted a series of qualitative focus group discussions with groups of non-Hispanic White and non-Hispanic Black older adults who recently underwent TKA. We used grounded theory approach, which asks the researcher to develop theory from the data that are collected. Participants discussed barriers and facilitators to accessing rehabilitation after surgery, opinions regarding their physical therapists, the amount of postoperative physical therapy received, and overall satisfaction with the postoperative rehabilitation process. Thirty-six individuals participated in focus groups. Three major themes emerged: (i) Participants reported overall positive views of their post-TKA rehabilitation experience. They particularly enjoyed one-on-one care, the ability to participate in "prehabilitation," and often mentioned specific interventions they felt were most helpful in their recovery. (ii) Despite this, substantial barriers to accessing physical therapy exist. These include suboptimal pain management, copayments and other out-of-pocket costs, and transportation to visits. (iii) There were minor differences in the rehabilitation experiences between Black and White participants. Black participants reported longer paths toward surgery and occasional difficulty interacting with rehabilitation providers. Individuals undergoing TKA can largely expect positive rehabilitation experiences postoperatively. However, some barriers to postoperative physical therapy exist and may differ between Black and White patients. Physical therapists should increase their awareness of these barriers and work to minimize them whenever possible.

Covid-19 Impacts on Florida’s Healthcare Professionals

This study described how COVID-19 impacted employment, telehealth usage, and interprofessional collaboration. A cross-sectional survey was deployed in June 2020 to healthcare professionals in Florida. Job status was uniquely separated by profession, with more nurses and medical doctors reported having no effect, and more mental health counselors transitioned to telehealth. Over a third of rehabilitation providers reported being furloughed. Over forty percent of providers had no training in telehealth, yet 33.1% reported an increase in usage. Interprofessional interactions are lower across professions during the pandemic, compared with before. This study shows the need for additional training on telehealth and interprofessional collaboration.

Examining the Availability and Accessibility of Rehabilitation Services in a Rural District of South Africa: A Mixed-Methods Study.

Introduction: Rehabilitation services aim to optimise individuals’ functioning and reduce disability. However, people with disabilities, who represent a key population of users of rehabilitation services, continue to have unmet needs for rehabilitation services that include the provision of assistive devices. This paper examines the availability and accessibility of rehabilitation services in a rural district of South Africa in order to explore why unmet needs for rehabilitation services persist. Methods: All nine district hospitals in a rural district of South Africa were included in the study. Rehabilitation services capacity was assessed by examining the available assistive devices, consumables and human resources at the level of the health facility. Data collection was conducted using the Global Co-operative Assistive Technology [GATE] Assistive Products List, AT2030’s ATScale priority list and the South African National Catalogue of Commodities for Primary Health Care Facilities. Descriptive statistics were then used for the analysis. For the qualitative component, semi-structured interviews were conducted with adults with physical disabilities at household level to explore barriers to accessing assistive device inclusive rehabilitation services and the consequences thereof in the same rural district. An interview guide based on the WHO health system building blocks was used. Thematic content analysis guided the analysis of the interview transcripts. Findings: The findings of the research demonstrate that rehabilitation service capacity in the district was constrained as a result of low availability of assistive devices [2–22%] and consumables [2–47%], as well as, possibly, a shortage of rehabilitation providers [n = 30] with an unequal distribution across health facilities [n = 9]. In addition, people with physical disabilities reported poor referral pathways, financial constraints, transport and road consideration and equipment unavailability as barriers to accessing rehabilitation services. Moreover, these barriers to access predisposed individuals to finance-, health- and person-related harm. Conclusion: Rehabilitation service availability is constrained by a lack of service capacity in rural South Africa. In addition, the rehabilitation services in district hospitals are not adequately accessible because of existing barriers to enable key populations to achieve optimised functioning.

Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

Identifying and treating late dysfunction in survivors of head and neck cancer (HNC) is important; however, an effective way to do so is not established. A quality improvement initiative altering our HNC survivorship clinic to include surveillance by rehabilitation providers was undertaken. The nature of dysfunction identified, along with the number and type of referrals to ancillary/support services were collected and compared to baseline. The baseline, single-provider, clinic evaluated 61 patients and referred 2 (3%) to ancillary/support services. Fifty-seven patients were evaluated in the interdisciplinary clinic, with 36 (63%) referred to at least one ancillary/support service for new/progressive dysfunction. Of 59 referrals made, 22 (37%) were for dysphagia, 17(29%) were for neck/shoulder dysfunction, and 28 (47%) were attended by the patient. Many HNC survivors exhibit late dysfunction appropriate for referral to ancillary/support services. A survivorship clinic including surveillance by rehabilitation specialists may optimize identification of dysfunction.

Exploration of Gender-Sensitive Care in Vocational Rehabilitation Providers Working With Youth With Disabilities: Codevelopment of an Educational Simulation.

BackgroundAlthough research shows that there is a need for gender-specific vocational support to help youth with disabilities find employment, health care providers often report needing more training in this area. Currently, there are no existing educational simulations of gender-sensitive care within vocational rehabilitation for clinicians who provide care to youth with disabilities. Therefore, developing further educational tools that address gender-sensitive care could help them enhance the care they provide while optimizing patient outcomes.ObjectiveThis study aims to codevelop an educational simulation and identify issues relevant to providing gender-sensitive care within the context of vocational rehabilitation for youth with disabilities.MethodsWe used a qualitative co-design approach with a purposive sampling strategy that involved focus group discussions and journal reflections to understand and address issues relevant to gender-sensitive care within vocational rehabilitation for those working with youth with disabilities. A total of 10 rehabilitation providers participated in two sessions (5 participants per session) to design the web-based simulation tool. The sessions (2.5 hours each) were audio recorded, transcribed, and analyzed thematically.ResultsTwo main themes arose from our analysis of codeveloping a simulation focusing on gender-sensitive care. The first theme involved the relevance of gender within clinical practice; responses varied from hesitance to acknowledging but not talking about it to those who incorporated gender into their practice. The second theme focused on creating a comfortable and safe space to enable gender-sensitive care (ie, included patient-centered care, effective communication and rapport building, appropriate language and pronoun use, respecting gender identity, awareness of stereotypes, and responding to therapeutic ruptures).ConclusionsOur web-based gender-sensitive care simulation that addressed vocational rehabilitation among youth with disabilities was cocreated with clinicians. The simulation highlights many issues relevant to clinical practice and has potential as an educational tool for those working with young people with disabilities.

Patient and Provider‐Reported Satisfaction of Cancer Rehabilitation Telemedicine Visits During the COVID‐19 Pandemic

IntroductionThe coronavirus disease 2019 (COVID‐19) pandemic has accelerated the growth of telemedicine services across the United States. In this study, we examined cancer rehabilitation patient and physician satisfaction with telemedicine visits. We also sought to evaluate the types of provider services that are given during telemedicine visits.ObjectiveTo assess overall patient and provider satisfaction with telemedicine visits and explore whether satisfaction varied by contact method (phone or video) and encounter type (new problem, worsening problem, stable/improving problem).DesignProspective survey study.SettingCancer rehabilitation program at an academic medical center.ParticipantsThree cancer rehabilitation providers and 155 unique patients participated in the study.InterventionsNot applicable.Main Outcome MeasuresProvider and patient satisfaction measured by customized surveys.ResultsOne hundred eighty‐four encounters with 169 unique patients were scheduled. Of these, 14 were new visits and 170 were follow‐up visits. Eighteen encounters (9.8%) were either no shows or rescheduled, making for 166 encounters with 155 unique patients. Patient and provider responses comprised the following: 94.8% of patient responses reported “quite a bit” or “very much” for the telemedicine visit being a good experience; 63.1% of patient responses reported “quite a bit” or “very much” for interest in using telemedicine visits in the future; and 83.9% of provider responses reported “quite a bit” or “very much” for the patient's main problem being addressed by the visit. Providers were more likely to prefer an in‐person visit for a new or worsening problem versus a stable/improving problem. The most common services provided were medication prescription/titration and education/counseling. The least common services provided were making of new diagnoses, ordering interventional procedures, and making referrals.ConclusionTelemedicine visits were well received by both patients and providers in a cancer rehabilitation medicine clinic setting. However, in the case of a new or worsening problem, satisfaction declined. These data support that telemedicine visits should be considered essential as part of comprehensive cancer rehabilitation care, especially during a public health crisis.

Parenting individuals with intellectual and developmental disabilities in South India

PurposeThere is limited research on the needs and expectations of parents of children with Intellectual and Developmental Disabilities (IDD) and associated complex communication needs (CCNs) in South India. The current paper will present the findings from a study that explored parents' needs and expectations, including those related to rehabilitation. MethodThis study adopted an Interpretative Phenomenological Analysis framework to understand the needs and expectations of 16 parents of 15 children with IDD and associated CCNs. Data were analyzed for the whole group, and two subgroups: parents of children 12 years or younger, and parents of adults and adolescents older than 12 years. ResultData analysis highlighted the following: (1) unmet or undermet needs and expectations with regard to children’s social participation, societal and familial support, childcare needs, financial requirements, and need for information; (2) changing needs and expectations of parents as their children grow older; (3) inadequacy of social participation and interaction opportunities for the participants’ children. ConclusionIt was concluded that rehabilitation providers including Speech Language Pathologists (SLPs) need to be aware of parents’ needs and expectations and collaborate with the families to attain rehabilitation goals that facilitate social participation.

Reframing Hospital to Home Discharge from "Should We?" to "How Can We?": COVID-19 and Beyond.

The pressure to discharge patients from the hospital quickly has intensified with the ongoing coronavirus‐2019 (COVID‐19) pandemic as bed and staff availability are paramount. 1 , 2 In addition, patients and caregivers are eager to return home where the risk of viral transmission is less. This is especially important for older adults who are at the greatest risk for complications and mortality if they contract COVID‐19. 3 , 4 Rehabilitation providers contribute uniquely to interdisciplinary discharge planning by providing critical evaluation of a patient's functional abilities and rehabilitation prognosis in the context of the individual's medical complexity, hospital course, psychosocial factors, and environmental features (i.e., home set‐up). 5 , 6 The COVID‐19 pandemic has retained these elements as critical to discharge planning. 7 However, there has been a major shift in perspective from which we view and make discharge decisions from “Should we discharge this person to home?” to “How can we make a discharge to home possible?” To be clear, safe and coordinated discharge planning has remained a priority during the pandemic. Some hospitalized older adults still require discharge to post‐acute care facilities (e.g., inpatient rehabilitation facilities, skilled nursing facilities, transitional care units) to maximize their functional recovery before returning home. Yet, for hospitalized older adults who may be considered “on the fence” for discharge to home versus a post‐acute rehabilitation facility, many rehabilitation and interdisciplinary providers have now reframed how they involve the patient and support network in the discharge planning. The purpose of this commentary is to outline a shift in the perspectives of rehabilitation providers on discharge decision‐making during the COVID‐19 pandemic by incorporating greater integration of caregivers in the discharge planning and increasing the use of shared‐decision making approaches. If changes in the process of hospital discharge decision‐making continue beyond the end of the COVID‐19 pandemic, then further evaluation of their effects (intended and unintended consequences) on system, clinical, and patient‐centered outcomes is warranted.

Making the Case for Patient-Reported Outcome Measures in Big-Data Rehabilitation Research: Implications for Optimizing Patient-Centered Care

Advances in data science and timely access to health informatics provide a pathway to integrate patient-reported outcome measures (PROMs) into clinical workflows and optimize rehabilitation service delivery. With the shift toward value-based care in the United States health care system, as highlighted by the recent Centers for Medicare and Medicaid Services incentive and penalty programs, it is critical for rehabilitation providers to systematically collect and effectively use PROMs to facilitate evaluation of quality and outcomes within and across health systems.This editorial discusses the potential of PROMs to transform clinical practice, provides examples of health systems using PROMs to guide care, and identifies barriers to aggregating data from PROMs to conduct health services research. The article proposes 2 priority areas to help advance rehabilitation health services research: (1) standardization of collecting PROMs data in electronic health records to facilitate comparing health system performance and quality and (2) increased partnerships between rehabilitation providers, researchers, and payors to accelerate health system learning. As health care reform continues to emphasize value-based payment strategies, it is essential for the field of physical medicine and rehabilitation to be at the forefront of demonstrating its value in the care continuum.

The Cancer Rehabilitation Medicine Metrics Consortium: A Path to Enhanced, Multi-Site Outcome Assessment to Enhance Care and Demonstrate Value.

PurposeA primary objective stated at the Cancer Rehabilitation Symposium at the National Institutes of Health was to improve outcome measurement. The purpose of this project was for the Cancer Rehabilitation Medicine Metrics Consortium (CRMMC) to develop an assessment tool to evaluate function in cancer patients via a data-driven and methodologically sound process. There is no agreed-upon measure of physical and cognitive function for cancer patients, making it difficult to demonstrate the value of rehabilitation interventions. Cancer patients are a particularly challenging population, with many tumor- and treatment-related variables impacting function.MethodsInvestigators from nine different cancer rehabilitation programs participated in a modified-Delphi process to delineate necessary aspects of an ideal patient assessment tool, including instrument type, domains evaluated, applicability across a range of patient traits, clinical feasibility, and item response characteristics. This involved numerous meetings, data review, and analysis of items involved in patient assessment.ResultsThe CRMMC developed a 21-item patient-reported outcome measure based on item response theory. The process by which the short form was developed was documented and provides a framework for other clinicians to follow. ConclusionThis document provides a framework for rehabilitation providers to follow when developing an assessment tool. This process is described in a stepwise fashion for reproducibility even in different, non-cancer populations.

Perspectives of physiotherapists and rehabilitation providers on the outbreak of COVID-19 pandemic and potentially therapeutic roles

By the end of 2019 and the initial of 2020, similar symptoms of severe acute respiratory syndrome (SARS) pandemic are presented in China Extraordinarily, COVID-19 has extensively spread worldwide within the last three months affecting humans' life and causing permanently a fearing sensation among all populations All agencies worldwide recommended their populations to stay home to prevent and terminate this fatal infectious disease During exposure to any pandemic infectious disease over history, many modalities of the treatment were reported to control and prevent its prevalence such as improving the public health, rehydration, and vaccinations that became the ideal strategies to exterminate these infectious diseases No treatment modalities were reported to prevent or control the COVID-19 infection Therefore, we have to highlight the role of physical therapy and rehabilitation against the outbreak of viral infection This manuscript suggests that physical therapy and rehabilitation may eliminate the common harmful respiratory, circulatory, and physical complications that follow the exposure to viral infections Also, it explains that the rehabilitation program may present an effective approach to retrieve physical and psychological functions besides medical treatment In conclusion, serious recommendations have to be considered for conducting exercise training and telerehabilitation to prevent and control the outbreak of COVID-19

Rehabilitation Providers’ Perspective on Recovery Following Autologous Chondrocyte Implantation: A Qualitative Study

Rehabilitation Providers’ Perspective on Recovery Following Autologous Chondrocyte Implantation: A Qualitative Study

Life is about “constant evolution”: the experience of living with an acquired brain injury in individuals who report higher or lower posttraumatic growth

Objective To explore the experience of living with an Acquired Brain Injury (ABI) in individuals who report higher or lower posttraumatic growth (PTG). Method A multi-method design was employed. Participant scores on the Posttraumatic Growth Inventory (PTGI) were used to identify groups for qualitative comparative analysis. Individual semi-structured interviews were conducted with fourteen individuals with ABI. Data were analysed thematically. Results Four themes emerged. The first two themes: “In my mind I was fine” surviving in aftermath of acquiring a brain injury and The everyday as “derailing” capture the transition process from an initial rehabilitation state characterised by neuropsychological and avoidance coping, towards active rebuilding for PTG. Internal building blocks for PTG and Growing in the social world: “you need to have that social connection” elaborate on the internal (e.g., acceptance, integration of the pre and post-injury self) and external (e.g., social relationships) factors seen to facilitate or obstruct PTG. Conclusions Under certain conditions, individuals living with ABI may construe positive growth from their experiences. Practitioners can support PTG development by providing individual and family-based supports aimed at increasing acceptance, the integration of self, and social connection throughout all stages of ABI rehabilitation. IMPLICATIONS FOR REHABILITATION Internal factors such as having a flexible and positive mindset and external factors such as one’s social environment can affect how individuals living with an ABI construe positive growth. Individuals with ABI and their families require access to individualised longitudinal support for neuropsychological and social challenges that can result in increased distress and obstruct the development of PTG. Efforts to facilitate acceptance and support the integration of the pre and post-injury self through recognition of continuity of self and processing of new schematic beliefs can benefit PTG development. Rehabilitation providers should support individuals with ABI to develop or maintain a positive social identity within new or existing social groups.

Current Status of Prosthetic and Orthotic Rehabilitation Services in India: Its Issues and Challenges

Introduction: The study purpose is to identify the issues and challenges of the Prosthetic and Orthotic (P&O) rehabilitation services in IndiaMaterial and Methods: The online search strategy included electronic search engine databases: Google Scholar, PubMed, Google, and Medline along with websites search of world Health Organisation, Government of India relevant Ministries, and Rehabilitation Council of India. All relevant articles were included and included in the present study.Results: In the future, the population growth, older population, increased risk of accidents and other complications may result in more prosthetic and orthotic service demand. To improve their access to the environment and income prosthetic and orthotic rehabilitation needs to be endorsed at the grassroots level. Health care expenses can be reduced through better Prosthetic and Orthotic rehabilitation services. and the user's quality of life may enhance through improved movement.Conclusion: Policymakers and the leaders of health, rehabilitation, and social care providers should facilitate access to appropriate prosthetic and orthotic technology that provides functional and economic independence. As functioning prosthetic and orthotic device will promote social acceptance to the physically challenged and improve their quality of life, satisfaction, education, and job opportunities.

Rehabilitation characteristics and patient barriers to and facilitators of ACL reconstruction rehabilitation: A cross-sectional survey

ObjectivesTo investigate patient-reported rehabilitation characteristics and barriers to and facilitators of ACL reconstruction rehabilitation. DesignSurvey-based study. SettingOnline survey platform. ParticipantsAdults 1–20 years post ACL reconstruction (n = 304). Main outcome measures1) rehabilitation characteristics, 2) barriers to and facilitators of rehabilitation. ResultsFear of re-injury (43.8%) was the highest rating barrier to rehabilitation adherence, while a good relationship with your rehabilitation provider was regarded as the most important factor (83.6%) in facilitating rehabilitation. Rehabilitation frequency reduced across the duration of rehabilitation from most commonly 1 x week (38.2%) in the first three months to once every month (26%) from 6 to 9 months. Almost all participants (95.7%) consulted a rehabilitation provider for the first six months. Only 43.4% of respondents returned to their previous level of sport. The exploratory analysis identified that low barriers to rehabilitation and a longer duration of supervised rehabilitation are associated with a faster return to sport, greater likelihood of return to previous level of sport and fewer reported ongoing problems with the knee. ConclusionsThis cross-sectional survey provides insight into the patient’s experience of rehabilitation practices and a patient’s perspective on the key barriers to and facilitators of ACL rehabilitation adherence and participation.

Health services coverage: Physical access to rehabilitation facilities in Tehran compare with the country.

OBJECTIVE:According to the World Health Organization, estimates about 1,800,000 people lived with disability in Tehran. Against there is little evidence of physical access to rehabilitation facilities in Tehran. This study is aimed to assess the physical access to physical rehabilitation facilities in Tehran and compare it with the country.METHODS:This is a cross-sectional study conducted since January to April 2017. We used a master facilities list of rehabilitation facility that developed in Iran to collect the information. The samples of this study included all existing physical rehabilitation centers in Tehran province. Data analysis was done using the SPSSr version 21.0 (SPSS Inc., Chicago, IL).RESULTS:The results showed that rehabilitation facilities existed at different levels, including inpatient (10.51), outpatient (224.28), community based (36.72), and long-term care (4.96)/1,000,000 populations. Rehabilitation services are provided by rehabilitation professional including: Physical medicine and rehabilitation specialists (8.7), physiotherapists (132.89), occupational therapists (57.4), speech therapists (42.11), and audiologists (48.84) (in 1,000,000 populations).CONCLUSION:Tehran needs to increase the physical access to rehabilitation facilities and compared with country was disproportionate physical access to facilities in most cases. It is necessary to establish an interdisciplinary referral system between different rehabilitation providers.

Using Systematic Functional Measurements in the Acute Hospital Setting to Combat the Immobility Harm

Hospitalized patients often experience unnecessary immobility and inactivity leading to direct harms and poor outcomes. Despite growing evidence that early and regular mobility and activity are safe and helpful for patients in the hospital, there remains substantial room for improvement in clinical practice. Key to improvement is establishing an interdisciplinary approach to measurement and communication using a common language of function. Here we provide a framework for systematic functional measurement in the hospital. We also provide 3 specific examples of how this framework has been used to improve care: (1) targeting specialized rehabilitation providers to the patients most likely to need their services, (2) generating a daily mobility goal for all patients, and (3) identifying patients early who are likely to require postacute care.

The Role of Rehabilitation in Reducing Resource Use and Lowering Hospital Readmission Through Discharge Planning

The transitions between medical settings, the community and back again is a complex and intimidating process for patients, families and caregivers. These transitions are vulnerable points where planning is key and must begin at the initial examination with rehabilitation providers (PTs/OTs,SLPs). These providers are key members of the healthcare team to facilitate effective transition management. In this session, attendees will learn the critical factors rehabilitation providers use to evaluate patients in order to facilitate successful care transitions. An overview of the indications for rehabilitation referral will be presented, as well as evidence for effective rehabilitation strategies. The speaker will present tools from the American Physical Therapy Association Home Health Toolbox and outline a decision-making process for care transitions based on the individual, caregivers, and health care providers to achieve successful transitions that reduce resource use and hospital readmission rates. Attendees will learn strategies to facilitate inter-professional collaboration, communication, and advocacy.

Identification of Functional Limitations and Discharge Destination in Patients With COVID-19

ObjectivesThe objectives of this study were to identify functional limitations in patients with coronavirus 2019 (COVID-19) admitted to acute care hospitals; to evaluate functional limitations by demographic, medical, and encounter characteristics; and to examine functional limitations in relation to discharge destination. Designand Setting:This is a cross-sectional, retrospective study of adult patients with COVID-19 who were discharged from 2 different types of hospitals (academic medical center and a community hospital) within 1 health care system from January 1 to April 30, 2020. ParticipantsPatients were identified from the Cedars-Sinai COVID-19 data registry who had a new-onset positive test for severe acute respiratory syndrome coronavirus 2. A total of 273 patients were identified, which included 230 patients who were discharged alive and 43 patients who died and were excluded from the study sample. InterventionsNot applicable. Main Outcome MeasuresFunctional limitations in patients with COVID-19 in acute care hospitals and the predictors for discharge disposition. ResultsA total of 230 records were analyzed including demographic, encounter, medical, and functional variables. In a propensity score–matched cohort based on age and comorbidity, 88.2% had functional physical health deficits, 72.5% had functional mental health deficits, and 17.6% experienced sensory deficits. In the matched cohort, individuals discharged to an institution experienced greater physical (62.7% vs 25.5%, P<.001) and mental health (49.0% vs 23.5%, P=.006) deficits than patients discharged home. Marital status (odds ratio, 3.17; P=.011) and physical function deficits (odds ratio, 3.63; P=.025) were associated with an increase odds ratio of discharge to an institution. ConclusionsThis research highlights that functional status is a strong predictor for discharge destination to an institution for patients with COVID-19. Patients who were older, in the acute care hospital longer, and with comorbidities were more likely to be discharged to an institution. Rehabilitation is a significant aspect of the health care system for these vulnerable patients. The challenges of adjusting the role of rehabilitation providers and systems during the pandemic needs further exploration. Moreover, additional research is needed to look more closely at the many facets and timing of functional status needs, to shed light in use of interdisciplinary rehabilitation services, and to guide providers and health care systems in facilitating optimal recovery and patient outcomes.