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Why Certification for Post-Acute Stroke Care Matters

Transforming how rural patients and their loved ones evaluate options for stroke rehabilitation.

Walter Panzirer
Walter Panzirer

Helmsley Trustee

With the launch of a new certification from the American Heart Association, stroke patients will have access to faster, more effective recovery in skilled nursing facilities. The story of Helmsley’s work with the Association to develop this certification shows how much progress can be made when industry and philanthropy join forces.

When Helmsley began working with the Association on its Mission: Lifeline® Stroke initiative several years ago, we focused on improving the continuum of acute care for stroke—everything from bystander awareness to definitive treatment. Then we realized we weren’t looking at the complete picture.

After treatment, people need rehabilitation services, often intensive therapy, to have the fullest recovery possible. We know from research that up to 50% of stroke survivors experience chronic disability as a result,[1] and between 5-22% suffer a second stroke within a year.[2] Improving post-acute stroke care is an untapped domain for reducing disability and saving lives.

However, smaller hospitals and skilled nursing facilities like those that serve rural populations lacked uniform standards for stroke rehabilitation. Standards had mostly been focused on large hospitals and inpatient facilities in urban areas.

In short, rural folks faced inconsistencies when they sought post-acute stroke care. If a family member needed care, it was difficult to evaluate your options for stroke rehabilitation. There was no way to evaluate the quality of care for stroke rehabilitation, and more fundamentally, there were no uniform standards that these facilities strived to meet.

We have to realize that not everyone goes to the big hospitals, but no matter where someone goes for care, they should be receiving the best standard of care. Helmsley set out to level the playing field for rural residents.

So we asked questions. We worked with the American Heart Association, given their expertise in developing scientific standards, and funded the development of beta standards for post-acute care in 2019. After convening a writing committee to write the standards, the Association next recruited 18 facilities—rehabilitation hospitals and skilled nursing facilities—to participate in a pilot project to gather feedback and provide gap analyses of the standards relative to current practices, assessing compliance and feasibility.

The work of testing and revising the standards continued through the pandemic. In 2022, the beta standards went up for scientific review by the Association and received approval, after which the standards continue to undergo further testing in post-acute care sites across Iowa, Montana, Nebraska, and North Dakota with 63 facilities currently participating.

Today, the field of post-acute stroke care in rural areas is on the verge of transformation. Through adoption of these new standards by medical facilities, rural patients and their loved ones will be able to evaluate their options for stroke rehabilitation and know with confidence that they can choose the best one.

[1] Donkor ES. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Res Treat. 2018 Nov 27;2018:3238165. doi: 10.1155/2018/3238165. PMID: 30598741; PMCID: PMC6288566.

[2] Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association; e372