Why rehab hospitals are a ‘safety valve’ for the capacity crisis

White Plains, N.Y.-based Burke Rehabilitation Hospital recently earned a spot on U.S. News and World Report’s ranking of the top 50 rehabilitation hospitals in the U.S.

Led by Executive Director Scott Edelman, the 150-bed inpatient facility is part of New York City-based Montefiore Health System and will open its 15th outpatient site later this year. 

Mr. Edelman spoke to Becker’s about rehabilitative care’s growing role in the U.S. healthcare industry, and what he wishes more leaders understood about rehabilitation hospital operations.

Editor’s note: Responses have been lightly edited for clarity and length. 

Question: How has the role of rehabilitative care evolved within the healthcare industry in recent years?

Scott Edelman: Healthcare has evolved and changed significantly, with the move to keep patients out of the hospital at No. 1. We’re seeing a shift to outpatient and hospital at home. We only want folks to be in the hospital that are the sickest and need to be there. Post-acute care is the key to that throughput crisis, it is the safety valve for congested emergency departments and the lack of available beds across the continuum of care. We should be viewed as the solution to the throughput crisis.

Not all rehab is created equal. We work with all acute providers, and not only our health system, to alleviate the log jam and reduce patients’ length of stays in acute care. At Burke, our average length of stay is 14 days, and over 70% of our patients are [set up] with home care. We also have one of the lowest readmission rates in the country.

Q: How is Burke Rehabilitation integrating technology into its operational strategies?

SE: Technology and innovation are central pillars of our operational and strategic approach, and AI is front and foremost. We adopt and implement technologies that help improve and enhance patient care, both in the inpatient and outpatient settings.

Healthcare has been a little slow to adapt to AI, and we do not want to find ourselves behind industry. So here at Burke, we are moving fast and furious, using AI every day in different therapeutic approaches.

I’m very excited to see how AI can help us on the front end, getting a patient in, clearing the patient for care, but I’m equally excited about technology advancements on the back end with wearables and post-discharge, following the patient, keeping them out of emergency rooms. 

We’re being very careful with vendors we speak to, because a lot of them have no proven record, no metrics. If we’re going to be a test bed for something, we have to believe in it, test it, make sure that we have the bandwidth and that it’s safe.

Q: What are some of the biggest challenges when it comes to improving transitions between acute and rehabilitative care settings?

SE: I think healthcare leaders should know — we want to make it simple, and the process is not simple. You don’t want the patient to sit in an acute hospital not doing anything and not getting better. We are the critical valve to getting those patients to the right setting.

What keeps me up at night is the misunderstanding that all rehab is created equal. If there’s one message, it’s to understand the distinctions across post-acute facilities. 

Maybe my hospital, which is inpatient rehab, is not always the correct setting. Maybe it is a skilled nursing facility where they’re too sick or not sick enough for three hours of rehab per day, but every patient has a suitable next step. 

Q: What excites you most about the future of rehabilitative medicine? 

SE: Last year, we introduced a different service line to complement our inpatient rehab. We are the first freestanding hospital in New York State that offers inpatient dialysis, so patients that are in end-stage renal but they need rehab. We couldn’t take those patients before, and we’re up to our 100th patient that we’ve been able to rehab because they have a dialysis need. And right now, we’re probably about two or three weeks away from introducing a service for patients who are on TPN, total parenteral nutrition. We’re figuring out now how we can get their hours of therapy in, get them stronger and see if we can wean them off the TPN while they’re here. 

I see us as a local, regional, and a global player in this industry. Not only do we also provide thought leadership, our clinicians are the best of the best. Every day I get to drive up to the campus is a privilege. Wearing the Burke logo is like walking down the street with a New York Yankees hat.

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