A Clinical Manual for Physiatry and Pain Management in Skilled Nursing Facilities
We empower nursing home staff, caregivers, and healthcare professionals with practical, evidence-based advice and strategies for delivering exceptional care to elderly residents and ensuring their dignity, comfort, and quality of life.
Content
The Manual guides healthcare professionals in providing high-quality, evidence-based care to elderly residents. Each chapter is structured to offer clear protocols, best practices, and interdisciplinary approaches tailored to the unique challenges of nursing home care. This manual emphasizes patient safety, functional independence, and quality of life and supports a holistic and practical approach to care in skilled nursing facilities.
This manual and website are intended for use by licensed clinicians and healthcare professionals. All clinical decisions and patient care actions remain the sole responsibility of the treating provider. The authors and publishers assume no liability for outcomes resulting from the use of this information.
For further information, read our Disclaimer
Chapter 1: Pain Management
Chapter 2: Geriatric Emergencies
Chapter 3: Injections
Chapter 4: Pulmonary Rehabilitation
Chapter 5: Cardiac Rehabilitation
Chapter 6: Stroke
About the Manual
The Manual for Skilled Nursing Facilities is a comprehensive resource designed to address the unique medical, rehabilitation, and pain management challenges skilled nursing facilities face. This manual provides actionable guidance tailored to the needs of administrators, nursing staff, therapists, and caregivers, equipping them with the knowledge to optimize care for one of our most vulnerable populations.
Whether you are a seasoned professional or new to long-term care, this manual offers step-by-step approaches to geriatric emergencies, chronic condition management, pain relief strategies, and more. It promotes interdisciplinary collaboration, fostering an environment where administrators, nurses, therapists, and families can work together to create the best outcomes for residents.
This manual and website are intended for use by licensed clinicians and healthcare professionals. All clinical decisions and patient care actions remain the sole responsibility of the treating provider. The authors and publishers assume no liability for outcomes resulting from the use of this information.
If you have any specific questions or would like to schedule a personal consultation with one of our consultants, please use our contact form.
Who this is for
Nursing Home Administrators: To enhance facility operations, streamline care coordination, and improve patient and family satisfaction.
Nursing Staff: To provide immediate access to specialized strategies for pain management, spasticity, and complex rehabilitation techniques.
Rehabilitation Professionals (PT/OT/Speech): To support tailored therapeutic interventions, equipment recommendations, and collaborative planning.
Social Workers: To guide psychosocial support, care transitions, and communication between families, clinical teams, and community resources.
Physicians and House Staff: To ensure continuity of medical management, interdisciplinary collaboration, and evidence-based approaches to pain and rehabilitation care in the SNF setting.
Families and Caregivers: To help answer questions about treatment options, pain management, and the transition of care for their loved ones.
Why this manual matters.
By Marc J Rosenblatt, D.O., FAAPMR, FAOAPMR, Medical Director ARC
This manual—and the resources on this page—come from my years of firsthand experience and a deep commitment to improving care in skilled nursing facilities.
After decades in physiatry and interventional pain management, the COVID-19 pandemic shifted my work from outpatient centers to nursing homes. I chose to stay after the crisis ended—because what I saw there couldn’t be ignored.
Pain was being overlooked or poorly managed. Patients were left on high-dose opioids weeks after surgery, lacking braces, stump care, or spasticity treatment. Many waited months for basic joint injections due to limited access and transportation. Staff often didn’t know how to use the tools we regularly rely on in physiatry to improve function and reduce suffering.
When I asked why, a rehab director told me: “Because no one cares about old people.”
We do!
That’s why I wrote this manual. That’s why I’ve dedicated the rest of my career to advancing pain management and physiatry care in skilled nursing facilities. The resources below are here to help you do the same—for comfort, dignity, for every patient.