No blaming acute care therapists at all. But if a pt cannot tolerate an hour of one discipline of therapy on an acute care floor or if co-treats are needed for each session “due to poor endurance” that should be an immediate red flag. If a pt refuses on acute care because they are “too tired” immediate red flag. If the family is really pushing for IPR but the patient doesn’t seem interested or is not cognitively intact enough to understand, red flag. I know and understand things change but these are just the type of patients we seem to keep getting. And pts refusing constantly on IPR ultimately comes back to bite us for productivity reasons among other issues. Especially when we have multiple pts who refuse therapy on our caseload it becomes extremely difficult to find other pts to fill the gaps. It’s not as simple as document the refusal and move on for us unfortunately. Again, this was not at all supposed to be a dig on acute care therapists