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Guidelines and Resources

Acute to Inpatient Rehab/CCC
Hospital Chronic Care Co-Payment: Questions and Answers This link, located on the Ministry of Health website, provides information on the chronic care co-payment.
Referral Guideline for Bedded Levels of Rehabilitative Care (July 2019) This updated guideline is in alignment with the provincial Definitions Framework for Bedded Levels of Rehabilitative Care. It provides criteria to determine eligibility for bedded/inpatient rehabilitative care, including criteria for rehab readiness, ALC designation, and timing and number of referrals to submit. It also includes response categories for submitted referrals.  
Inter-Organizational Transfer of Accountability (TOA) Guideline
Inter-Organizational Transfer of Accountability (TOA) Guideline (June 2019) This guideline provides six principles that support the interactive process of transferring information and coordinating follow-up care between organizations across the patient lifespan and care continuum. 
Discharge Information Checklist (June 2019) This checklist outlines key information that should be provided at the time of transfer to the next level of care (to hospital or community) in order to support patient safety and continuity of care. 
Provincial Definitions Frameworks and Resources
RCA Definitions Framework for Bedded Levels of Rehabilitative Care (July 2017) Framework used across Ontario. Defines four bedded levels of care. More resources to support its use are available on the Rehabilitative Care Alliance (RCA) website. 
Key features of RCA Bedded Levels of Rehabilitative Care (July 2017) Key features of each of the levels of rehabilitative care. 
RCA Definitions Framework for Community-Based Levels of Rehabilitative Care (March 2015) Framework used across Ontario. Defines two levels of rehabilitative care provided in the community. More resources to support its use are available on the Rehabilitative Care Alliance (RCA) website. 
Key features of RCA Community-Based Levels of Rehabilitative Care (March 2018) Key features of each of the community-based levels of rehabilitative care.

Webinar on re-alignment of RM&R with RCA bedded levels of rehabilitative care (Rev. Sept 2018)

GTA Rehab Network webinar provides information to assist those referring from acute care to inpatient rehab/CCC, including the rationale for RM&R re-alignment with the RCA Definitions Framework for Bedded Levels of Rehabilitative Care; RM&R changes; and key features of the bedded levels. 
Total Joint Replacement
Guidelines for TJR Pre-operative Processes (Rev. Nov 2019) This guideline includes processes in the pre-operative, acute care admission and outpatient rehabilitation phases; pre-operative triage considerations for referral to outpatient/inpatient rehabilitation; and referral criteria for Home and Community Care.
TJR Outpatient Rehab Model of Care and Process Maps (Rev. Feb 2018) These process maps include responsibilities for acute care and inpatient rehabilitation to support the smooth transition of patients to outpatient rehabilitation. 
Other
Patient Complexity Framework (2017) A resource developed by the Network and the Toronto Stroke Networks to help providers identify which patients have "complex needs" and would benefit from early discharge planning to facilitate access to rehab and community care.