Admissions & Referrals
A referral for inpatient rehabilitation, specifically to Braintree Rehabilitation Hospital, may be prompted by multiple people: patient, family members, physician, case manager, or insurance company. Sometimes a medical professional suggests Braintree Rehab based on the patient's medical needs. Sometimes a family member or the patient themselves inquire about Braintree Rehab based on their personal preference of location or reputation. Either way, it is your right to request a referral be placed to the facility of your choice. Note, if the referral request is made by a patient or family member who is currently in a facility, the representative from that facility must formally invite BRH in to proceed with the evaluation. Once a referral is made, the following process will occur.
- A Rehab Liaison from Braintree Rehabilitation Hospital conducts a comprehensive evaluation to determine if the patient meets criteria for acute rehabilitation. The screening includes a chart review, discussion with healthcare personnel, and a meeting with the patient and/or family to address pertinent information, concerns, and questions.
- Simultaneously, Braintree Rehabilitation Hospital's Admitting Office will verify insurance coverage and, if necessary, attempt to obtain prior authorization from the insurance company.
- The next available (appropriate) bed is offered to the patient. Often, this process may occur within hours but may be extended if awaiting authorization from the insurance company.
- If the patient does not meet acute rehab admission criteria &/or is denied pre-authorization from their insurance company, an explanation will be provided to the patient & other parties involved in the referral process. In most situations, an alternative post-acute rehabilitation level of care is more appropriate and will be recommended.
Braintree Rehabilitation Hospital is licensed as an Inpatient Rehabilitation Facility (IRF), also known as acute rehabilitation hospital. Because of our licensure, Medicare and some commercial insurance companies allow an inpatient admission from home, physician office, acute hospital, skilled nursing facility, long-term acute care hospital. In other words, there is no requirement for the patient to spend three (3) midnights in an acute hospital setting in order for Medicare to pay for their acute rehabilitation inpatient stay. The patient does need to meet the following admission criteria at the time of the referral/evaluation.
- Need 24-hour physician intervention
- Need 24-hour nursing care
- Ability to participate 3 hours therapy (over the course of an 8-hour day)
- Expected to exhibit significant progress within a reasonable amount of time
Within 24 hours of admission, a representative from Braintree Rehabilitation Hospital will meet with the patient and/or family to obtain consent to treat, review patient demographic information, including emergency contacts, and secure a copy of the patient's health insurance card(s). If applicable, copies of Advance Directive forms will be requested.
Inpatient rehabilitation is covered in full or part by most health insurance plans, including Medicare and Medicaid. Braintree Rehabilitation Hospital has contracts with major insurance companies and is willing to negotiate with other companies as needed. Please note that television and telephone services are not covered by insurance and you will be billed separately if you choose to have these services. Questions about inpatient insurance coverage or services can be answered by calling 781-348-2138.
2012 Medicare Coverage (.pdf)