New rehabilitation evaluations
Physiatric evaluation of newly admitted or newly referred residents with significant rehabilitation, neurologic, or functional needs.
Facility Services
Physician-led rehabilitation support for post-acute care
NWA Physiatry works with skilled nursing facilities, rehabilitation facilities, and other post-acute organizations to provide Physical Medicine & Rehabilitation expertise focused on function, mobility, rehabilitation progress, and complex rehabilitation needs.
The Physiatry Role
Why PM&R in post-acute care?
Residents in post-acute settings frequently have medical and functional issues that overlap. A change in mobility, tone, comfort, or independence is rarely explained by a single diagnosis alone.
A physiatrist brings physician-level rehabilitation expertise to questions involving functional recovery, mobility, abnormal tone and spasticity, neurologic deficits, amputation and prosthetic care, musculoskeletal barriers, equipment needs, rehabilitation goals, and complex transitions following acute hospitalization or inpatient rehabilitation.
The intent is added clinical perspective on rehabilitation and function—not a replacement for the medical, nursing, or therapy care already in place.
Consultation Model
What a facility relationship may include
The components below are examples of physiatric support that a post-acute organization may choose to build into a working relationship. Not every relationship includes every element.
Ongoing physiatric follow-up
Continued medical rehabilitation management for selected residents when clinically appropriate, with attention to functional progress and changing needs.
Rehabilitation rounds
Structured review of residents with notable functional, neurologic, musculoskeletal, tone, or equipment concerns.
Interdisciplinary collaboration
Coordination with facility clinicians and therapy teams around rehabilitation priorities, functional goals, and equipment planning.
Clinical Population
Residents who may benefit from physiatric evaluation
Physiatric consultation may be appropriate for residents with diagnoses or functional concerns such as:
- Stroke
- Brain injury
- Spinal cord injury
- Parkinson's disease
- Multiple Sclerosis
- Cerebral Palsy
- Functional decline
- Spasticity or abnormal muscle tone
- Dystonia
- Contracture risk
- Recent amputation
- Prosthetic-related concerns
- Phantom limb pain or sensation
- Mobility limitations
- Difficulty with transfers
- Wheelchair or equipment needs
- Joint pain
- Tendinopathy
- Myofascial pain
- Ongoing rehabilitation needs after hospitalization or inpatient rehabilitation
Not every resident in these categories requires physiatric consultation. Clinical appropriateness is determined case by case with the facility team.
Therapy Partnership
Working alongside PT, OT, and speech therapy
Therapy teams deliver direct, hands-on rehabilitation. Dr. Drake contributes physician-level rehabilitation evaluation and medical management that complements that work.
Physiatric input may include:
- Identifying medical or functional barriers that affect participation in rehabilitation
- Reviewing rehabilitation progress alongside the therapy team
- Helping clarify realistic functional goals
- Evaluating spasticity, abnormal tone, and contracture risk
- Reviewing equipment, orthotic, and prosthetic needs
- Medication management related to confirmed PM&R conditions when appropriate
- Considering procedures within confirmed scope when clinically appropriate
- Supporting rehabilitation planning and next-step recommendations
Neurologic & Tone Care
Neurologic rehabilitation, spasticity, and tone
Neurologic diagnoses
Physiatric evaluation for residents with stroke, brain injury, spinal cord injury, Parkinson's disease, Multiple Sclerosis, and Cerebral Palsy focuses on how these conditions affect mobility, positioning, comfort, care needs, and participation in rehabilitation.
Spasticity, dystonia, and contracture risk
Increased tone, spasticity, and dystonia can interfere with transfers, positioning, hygiene, and comfort, and may contribute to contracture risk over time. Evaluation includes pharmacologic management when appropriate, and botulinum toxin treatment may be considered when clinically appropriate and operationally feasible at the facility.
Amputee & Mobility Care
Amputation, prosthetics, and mobility needs
Post-amputation evaluation & prosthetic management
Evaluation following amputation, assessment for prosthetic prescriptions, and ongoing prosthetic management as residents progress through rehabilitation.
Residual limb & phantom limb concerns
Evaluation of residual limb concerns related to prosthetic use, including skin irritation, wounds associated with prosthetic wear, associated pain, phantom limb pain, and phantom limb sensation.
Wheelchair & mobility evaluation
Assessment of wheelchair, seating, and mobility equipment needs in the context of a resident's functional goals and daily care requirements.
Orthotic & prosthetic recommendations
Clinical recommendations and prescriptions for bracing, orthotics, and prosthetic components, coordinated with the facility team and prosthetist or orthotist.
Musculoskeletal Care
Musculoskeletal barriers to rehabilitation
Joint pain, tendinopathy, myofascial pain, and other movement-related limitations can interfere with a resident's comfort, participation in therapy, and day-to-day function.
These concerns can be evaluated as part of physiatric care, with nonoperative management directed at the functional impact of the problem. Trigger point injections may be considered when clinically appropriate.
Care-Team Role
How physiatry fits into your existing team
Physiatric consultation is complementary. The resident's attending physician continues to direct primary medical care, and Dr. Drake concentrates on rehabilitation, function, mobility, and recovery.
Collaborating with:
- Attending physicians and APPs
- Nursing leadership and floor nursing staff
- Physical therapy
- Occupational therapy
- Speech-language pathology
- Case management and social work
- Prosthetists and orthotists
- Other treating specialists
Transitions of Care
Family discussions and discharge planning support
When clinically appropriate, physiatric input may support the facility team in the following areas:
Rehabilitation goal discussions
Helping residents, families, and staff understand functional priorities and what rehabilitation is working toward.
Functional expectations
Candid discussion of functional trajectory and rehabilitation considerations, without guarantees about recovery.
Equipment & mobility planning
Input on wheelchairs, bracing, prosthetic components, and mobility equipment needs as discharge approaches.
Caregiver considerations
Discussion of transfer, positioning, and daily care factors that caregivers may encounter at home.
Transition planning input
Rehabilitation-focused perspective contributed to the facility's discharge planning process.
Rehabilitation follow-up
Coordination of continued physiatric follow-up after discharge when appropriate.
Engagement Model
Structuring a relationship around your organization
Facility relationships can be shaped around the clinical needs of the organization and its residents. Examples of possible structures include:
Recurring on-site consultation
Regular physiatric presence at the facility, structured around resident volume and clinical need.
Scheduled rehabilitation rounds
Dedicated review sessions focused on residents with complex rehabilitation and functional concerns.
Patient-specific consultations
Individual physiatric evaluations requested by the facility for specific clinical questions.
Ongoing follow-up for selected residents
Continued physiatric management for residents whose rehabilitation needs warrant longitudinal attention.
The scope and cadence of services can be tailored to the clinical needs of the facility and the terms of the final agreement.
Individual Patient Referrals
Referring a single patient instead?
Clinicians who would like to refer an individual patient for outpatient physiatric evaluation and management should use the Referring Providers page rather than this facility partnership pathway.
Explore a PM&R partnership for your facility
Administrators, medical directors, therapy leaders, and clinical leadership are welcome to contact NWA Physiatry to discuss the rehabilitation needs of your residents and how physiatric consultation might fit your organization. Please keep initial inquiries free of resident health information.
Office / Fax: 479-302-7040admin@nwaphysiatry.com