A wonderful non-clinical job for physical therapists is a rehab liaison. I know this because I was one for over two years!
What is a rehab liaison?
Any inpatient rehabilitation facility (also called acute rehab or acute inpatient rehab) needs to fill its beds with patients. Without patients, the facility would need to close its doors. Keeping the census high is the job of a rehab intake liaison.
What does a rehab liaison do?
A rehab intake liaison spends his or her days performing a variety of actions, all of which are directly - or indirectly - related to that end goal of bringing patients into the facility. But it’s not just patients in beds that make a liaison successful. Those patients need to be appropriate for acute inpatient rehab in the first place.
That’s why a general sales or marketing person won’t cut it in a liaison role; someone with a therapy or nursing background is always preferred.
A rehab liaison will spend his or her days in a variety of ways, including, but not limited to:
- Responding to evaluation orders
- Evaluating patients (not physically but in more of a case manager role)
- Admitting as many appropriate patients to their facility as possible
- Obtaining as many patient referrals as possible
- Spreading the word about the facility to physicians, nurses, case managers, and the general public
- Representing the facility at various marketing and social functions
Generally, the rehab liaison will start his or her day responding to evaluation orders, just like a normal physical therapist would. Orders are written by physicians, nurses, or case managers, and might come from the same facility where the liaison works, or they might come from a different facility.
Once the order is received and confirmed to be accurate, the liaison’s job is to identify whether a particular patient will qualify for, and benefit from, acute inpatient rehab.
There are many considerations when looking at whether a patient will qualify for acute rehab. Some of these include:
- Insurance coverage - Different insurance companies will cover different diagnoses, ages, and conditions. The rules are always changing, so most intake teams keep a comprehensive database of insurance policies, which they update regularly.
- Age - Certain diagnoses, such as hip fractures, are covered, but only for certain age groups.
- Prior level of function (PLOF) - If a patient was bed-bound and confused prior to admission to a hospital, chances are they won’t qualify for acute inpatient rehab. But if the patient was mod A, or even max A with a committed family member, and now they’re total A, they might still qualify.
- The current level of function - As noted above, a patient’s level of function plays a key role in whether they’re admitted to inpatient rehab. If their current level of function is total A and they’re making very slow progress with therapy, even if they were independent before their current diagnosis, they might be better suited for a longer-term rehab option, such as an SNF.
- Diagnosis - Which diagnoses are accepted will depend on the types of insurance(s) the facility accepts, among other factors. Typically, neuro diagnoses are almost always accepted (if the patient meets other criteria), while musculoskeletal or medical diagnoses are more hit-or-miss.
- Length of stay in the hospital - A 1-2 day hospital stay might not qualify a patient unless they had a clear neuro diagnosis or one of several other scenarios. But someone who was in the hospital for 3 weeks with pneumonia might qualify under debility. You'll learn more about this on the job :)
- Medical history - Some insurances will only cover neuro diagnoses but, in some cases, a history of a CVA or TBI will enable an otherwise unqualified patient to attend. Again, these are things you'd learn on the job!
Much of this information will be obtained through case notes that a case manager will provide. In some cases, the liaison will have to obtain these notes directly from treating therapists, including physical therapists, occupational therapists, and speech therapists.
Rehab liaisons also coordinate the transfer of patients to the acute inpatient rehab facility, ensuring a seamless experience. For example, the liaison will be responsible for making sure a diabetic-friendly dinner is waiting for an amputee patient when they arrive late at night.
For example, a patient who just had a stroke might benefit greatly from 2 weeks of acute inpatient rehab, but if he or she can make similar gains through home health physical therapy or outpatient physical therapy, Medicare may deny payment.
Some inpatient rehab facilities will use Medicare’s acute inpatient rehab criteria for all patients, Medicare or not. This is because Medicare’s guidelines are often used as the benchmarks for other types of insurance. Many facilities will accept patients on a cash-pay basis and have separate paperwork and conversations that need to be had.
Additional duties of a rehab intake liaison
- Marketing. Liaisons will attend community events, doctors’ days' events, and drop off baskets around the holidays.
- Analytics. Rehab liaisons are expected to analyze their numbers month-over-month to determine admission trends and tweak job duties accordingly.
What does a rehab liaison job pay?
Any financially savvy physical therapist or clinician saddled with physical therapy student loans will be wanting to know what a typical rehab liaison job will pay. I can only speak from my own experience, but the pay was good! I worked on a per diem basis, and I made the standard per diem pay for a PT at that facility. The same would have gone for any OT, nurse, ST, etc., who took the role.
From what I understand, the same applies to the part and full-time rehab liaisons; the pay is very similar to a treating therapist.
Rehab liaison pros:
- It’s a wonderful way to stay involved in the physical therapy field without the strain on your body. You will be evaluating, providing patient education, and working directly with therapy and nursing teams to synthesize information about patients.
- You still get to work in a multidisciplinary environment with other clinicians. Unlike going to a purely non-clinical role, a rehab liaison role is a happy medium between the physical and emotional demands of patient care and leaving the field altogether.
- You still use your clinical reasoning skills every day. One of the reasons why rehab facilities opt to hire physical therapists for rehab liaison roles is that they've got the experience to truly understand how quickly patients with different presentations will progress with intensive therapy. Having worked with patients in the past, PTs can determine whether a patient can handle 3 hours of intensive therapy per day, and also whether that patient will make enough gains to return home within a short time period.
- It’s an interesting, varied job, where no two days are ever the same. Just like hands-on physical therapy, you'll find that patients present with incredibly diverse medical and social histories, and no two cases are alike.
- You're not exposed to as many contagions as a treating therapist. This is great for immunocompromised folks, pregnant therapists, and people who are on the germaphobic side of the spectrum :)
Rehab liaison cons:
- You won’t really be using your PT skills in any physical manner. You might get rusty with manual therapy skills.
- Turning down patients who don’t qualify can be painful for patients, their families, and even you. Saying "no" isn't easy.
- It’s a numbers game. If you’re not comfortable with meeting census quotas, the role might not be for you. That said, some facilities are more stringent with demands than others. My facility was very understanding when our census dropped.
- You are frequently dealing with situations where a patient’s insurance changes or premiums weren’t paid on time. Sometimes, you have to rescind offers to join your program.
- The job can get stressful. When the orders are flying in, it can be tough to manage how to prioritize evaluating new patients, managing existing patients’ families' questions, and working with insurance companies. Luckily, many facilities have a per diem and/or part-time liaison for when things get busy.