As a board-certified rehabilitation nurse in Iowa, I see firsthand how Medicare Advantage plans systematically deny stroke survivors access to inpatient rehabilitation. These denials are not just bureaucratic red tape – they are life-altering and, in many cases, life-ending.

Inpatient rehabilitation facilities (IRFs) provide at least three hours of intensive therapy per day, the gold standard for stroke recovery. However, Medicare Advantage plans frequently steer patients toward lower-cost settings like skilled nursing facilities (SNFs), which provide, on average, less than one hour of therapy per day – an inadequate alternative. The result? Poorer patient outcomes, increased hospital readmissions, and long-term disability – ironically, the very costs these plans claim to reduce.

This isn’t just a healthcare issue – it’s a growing crisis in Iowa. I have personally seen stroke survivors in our community denied rehabilitation, leaving them with little chance of regaining independence. Families are forced to take on intense caregiving responsibilities, and local hospitals bear the burden of preventable readmissions.

Iowans deserve better.

Medicare Advantage insurers must be held accountable for these denials. Congress must demand greater transparency, stronger oversight, and policy changes that ensure stroke survivors receive the rehabilitation care they need.

I urge readers who care about this issue to take action. Call, write, or email your legislators and demand that they stand up for stroke survivors and protect access to inpatient rehabilitation. These decisions affect our families, our neighbors, and our entire healthcare system. We cannot afford to ignore them.

Dr. Christopher R. Crossett,

DNP, MBA, MSN, RN, RRN

Cedar Rapids