Predischarge home visits: A survey of in-patient rehabilitation facilities in the United States

Introduction: Data on predischarge home visits (PDHVs) by in-patient rehabilitation facilities (IRFs) in the United States (US) are limited. We evaluated how often IRFs conduct PDHVs and factors influencing their use. Method: A cross-sectional survey was conducted among IRFs registered with the Centers for Medicare and Medicaid Services (CMS; 2024-2025). Among 1224 IRFs, a stratified random sample of 538 was selected by CMS region. One participant (occupational/physical therapist, case manager, director/program manager) per IRF was allowed to participate. Results: Response rate was 11% ( n = 61/538). A total of 44% (27/61) conducted PDHVs within the past 12 months. Among these IRFs, the median approximate percentage of patients receiving a PDHV (based on self-reported/calculated estimates) was 1% (range: 0.1–64%). Considerations for conducting PDHVs were home setup (26/26, 100%), physical impairment (26/26, 100%), social support (22/25, 88%), and cognitive impairment (22/26, 85%). Among IRFs not conducting PDHVs, barriers were staffing (16/34, 47%), budget (15/34, 44%), and time (14/34, 41%). Over half (32/60, 53%) of participants believed PDHVs are critical for in-patient care. Conclusions: PDHVs were infrequently conducted by responding IRFs despite many practitioners viewing them as critical. Given resource constraints, further research should determine patients who benefit most and evaluate alternative methods, such as telehealth-based visits.