Examining Post Acute Care Relationships in an Integrated Hospital System. 3.1.2 Freestanding versus Hospital-based Inpatient Rehabilitation Facilities and Skilled Nursing Facilities


There were 1,203 IRFs in the United States in 2007 compared to 1,224 in 2006. The vast majority of IRFs are hospital-based (983, or 82.0 percent). Texas was the most densely populated in terms of IRFs, with 118 (84, or 71.0 percent hospital-based). After Texas, the three states with the most IRFs were Pennsylvania with 82 IRFs (64, or 78.0 percent Hospital-based), California with 79 IRFs (73, or 92.0 percent hospital-based), and New York with 70 (100.0 percent hospital-based). In contrast to these states, the majority of U.S. states had fewer than 20 IRFs. In fact, Hawaii had only one IRF in 2007. Though hospital-based units are more common than freestanding IRFs, IRF units are generally smaller and have a lower volume of admissions compared to freestanding IRF providers.

There were 15,056 SNF providers in 2007. SNFs are by far the most prevalent type of post-acute care facility in the U.S. In contrast to LTCHs and IRFs, the vast majority of SNFs were freestanding (13,929, or 93.0 percent). The three states with the most SNFs in 2007 were California, with 1,197 (1,063, or 89.0 percent, freestanding), Texas, with 1,075 (1,038, or 97.0 percent, freestanding), and Ohio, with 956 (916, or 96.0 percent, freestanding).

Home health agencies are also widely available across the United States. There were 9,286 HHAs in 2007. Of these, 17.3 percent were hospital-based and 82.7 percent were freestanding. States with the highest numbers of home health agencies include Florida (827 home health agencies) and Texas (1,738 home health agencies).

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