Rehabilitation Potential and How It Is Determined

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Rehabilitation potential is a projection about the future status of a patient based on present observable behaviors often called positive prognostic indicators. The rehabilitation potential is determined upon completion of the initial evaluation and updated and/or revised as needed as treatment progresses.  It is determined using objective diagnostic procedures, clinical observation of the patient and standardized tests. A prognosis is a prediction about the future status of a resident based upon current observable behaviors.  Prognostic statements and rehab potential together support the clinical judgment that the rehabilitation program is appropriate and will be successful if implemented. The diagnosis or prognosis is never the sole factor in deciding that a service is or is not skilled.  Positive prognostic behaviors are signs of good rehabilitation potential.  The following are examples of clinical indicators usually considered to be positive prognostic signs when they are intact:  Stimulability, orientation, ability to follow directions, attention span, self-expression (thoughts, feelings, needs), ability to solve problems, ability to imitate, medical stability, motivation to walk, talk, and achieve self-help skills, recent history of independence with functional skills/High PLOF, ability to self-monitor and/or self-correct, supportive family/caregivers, learning potential, recent onset, eye contact, awareness, initiation level, previous response to intervention, and responsive to cues/strategies. 

Negative prognostic rehabilitation behaviors may indicate poor rehabilitation potential. These signs may include the presence of intractable pain, poor orientation, inability to concentrate under maximum structure, extreme depression/uncooperativeness, medical instability, lack of ability to initiate activity, lack of self-control (impulsivity), absent or inadequate arousal, lack of ability to demonstrate mobility and/or self-care activities, and limited family/caregiver support. 

Record conditions that may affect medical status or success of therapy such as: 

• Weight-bearing status
• Use of oxygen
• Pulse Oximetry parameters
• Aspiration precautions
• Total hip precautions
• Statement of specific cardiac precautions from a physician