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Scope of Services

The Pediatric Inpatient Rehabilitation (IRU) program at St. Luke's Children's Hospital typically serves patients from 1-13 years of age; however, each case is reviewed individually. Patients 14 and older are generally admitted to St. Luke’s Rehabilitation Hospital, which is adjacent to St. Luke’s Children’s Hospital.  

We accept patients from across Idaho and surrounding regions. Physician referrals are required to start the review process. 

Population Served

Diagnoses considered appropriate for admission include but are not limited to:
  • Acquired brain injury
    • Traumatic brain injury
    • Non-traumatic brain injury (encephalitis/meningitis, anoxic brain injury, brain tumors and post-surgical seizure management)
    • Stroke/arteriovenous malformation (AVM)
  • Spinal cord injury (note: cervical levels may be considered for transfer to external specialty spine program)
    • Non-traumatic spinal cord injuries (transverse myelitis, acute flaccid myelitis and spinal cord tumors) 
    • Traumatic spinal cord injuries
  • Neurological disorders (Guillain-Barré syndrome and acute disseminated encephalomyelitis (ADEM)
  • Orthopedic conditions (post-surgery, trauma and amputation)
  • Cardiac or pulmonary conditions
  • Debility related to significant medical illness

Admission Criteria

Each case is evaluated individually, and admission decisions are based on patient/family needs and program services offered.

  • The patient must be deemed medically stable by the consulting team. The patient must require ongoing medical care by a pediatric physical medicine and rehabilitation physician who will oversee the course of treatment to maximize the patient’s benefit from the inpatient rehabilitation program.
  • The patient requires and can participate in 3 hours of occupational, physical and/or speech therapy a day, 5 days a week.
  • The patient should be able to follow one-step commands or show significant potential to follow commands.
  • The patient can be expected to make measurable improvements in functional areas such as mobility, motor skills, self-care, bowel/bladder, cognition, communication and/or swallowing.
  • There are preliminary plans for discharge established, as well as identified training and educational needs.
  • The patient and family must have needs and goals that can be met by the services offered in our rehabilitation program.
  • The patient and family must be willing to participate in the inpatient rehabilitation program.
  • Note: this unit is not the optimal setting for individuals with baseline severe behavioral conditions that may prevent participation and/or pose a threat to self and/or others in our program. Each patient's mental health history, current mental health status, and past or current behavioral corrections will be considered when evaluating appropriateness for admission.

Medical Acuity and Stability Considerations

Medical Acuity
The pediatric physical medicine and rehabilitation physician determines if patients are medically stable and ready for inpatient rehabilitation. Common considerations prior to transfer include:
  • Tracheostomies - patient must have had their first tracheostomy change at least 24 hours prior to transfer.
  • Stable respiratory support, including CPAP and BiPAP
  • Oxygen - patient’s oxygen needs must be considered stable without an increased need within 24 hours prior to transfer.
  • Chest tubes - patient must have had these removed at least 24 hours prior to transfer.
  • EVD - patient must have had these removed at least 48 hours prior to transfer.
  • PCA pump - patients must be weaned to oral medications prior to transfer.
Medical Stability
Patients are medically stable enough to participate in rehabilitation and to achieve maximum benefit from inpatient rehab services. The patient must be without fever, increased need for oxygen or acute change in medical condition for 24 hours prior to admission to the pediatric IRU.

Additional Areas of Support

  • Improving Ability in Daily Activities

    Our team supports patients in improving their ability to care for themselves, including tasks such as grooming, toileting, bathing, dressing, walking, talking, feeding and/or other daily tasks.

  • Navigating Physical Impairments

    We are accustomed to supporting patients that may have body function or structure challenges such as neurological motor impairments (hemiparesis, paraplegia, spasticity, ataxia, etc.), cognitive difficulties, orthopedic limb restrictions, neurogenic bowel/bladder, loss of vision and/or trouble swallowing.

  • Enhancing Participation

    We also help patients improve their ability to participate in their community, school, and home environments (i.e., managing community accessibility, school reintegration, church and/or family life, obtaining driver’s license, etc.).

  • Managing Psychological Status

    Patients may require support for issues related to adjustment, coping and/or family dynamics secondary to diagnosis.

Continued Stay and Discharge Criteria

  • Continued Stay Criteria

    • Patients are continually monitored to determine the ongoing needs and appropriateness of participation in our comprehensive inpatient rehabilitation program. Patients will be evaluated to determine progress toward treatment goals and the necessity of continued treatment.

      Input from the patient/family and the members of the interdisciplinary team are used to continually update the treatment plan and discharge planning.


      A patient is considered eligible for continued stay when:

      • There is evidence that the patient has reasonable potential to achieve their functional goals.
      • The members of the team can document significant and continued progress towards functional goals.
      • The patient and family can continue to actively participate in their care.
      • The patient requires ongoing medical and nursing needs that necessitate hospitalization while benefiting from continued therapy.

  • Discharge Criteria

    • The intended discharge environment for most patients is home; however, we  consider the least restrictive environment to meet the needs of the patient/family and the parent’s/caregiver’s ability to provide safe and effective patient care.

      Guidelines for discharge to home or transfer to the most appropriate level of care include, but are not limited to:

      • When the patient has achieved the goals of rehabilitation; caregivers have completed all necessary education and training; and a safe plan for discharge has been established.
      • When a patient reaches a sustained plateau and is unable to make further progress towards rehabilitation goals.
      • When the patient no longer requires interdisciplinary services to achieve rehabilitation goals or can achieve rehabilitation goals in a less intense setting.
      • When the patient experiences a major surgical or medical situation that interrupts or compromises their ability to participate in rehabilitation services, they will be transferred to another service, if deemed appropriate by the attending physical medicine and rehabilitation physician and additional consulting physicians.
      • When the patient displays behaviors that preclude benefit from a continued intensive rehabilitation program and/or the patient/family are no longer willing to be active participants in the program.
      • A non-voluntary discharge from inpatient rehabilitation may occur if the patient/family are asked to leave the program due to unacceptable behaviors.
      • When the patient/family exercises legal rights and refuses continued services.
      • When financial resources are no longer available.
      • When family feels that external factors support an expediated discharge.
  • Payer Sources and Fees
    Our program works with most insurance companies, state-funded Medicaid, and self-pay arrangements. St. Luke’s is in-network with most insurance plans, but may be considered out-of-network with others. Always check with your health plan for up-to-date coverage information.
  • Authorization Required
    Insurance authorization for this elective admission must be obtained prior to admission.
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