Nursing homes have undergone many changes since their initial emergence. Increased state regulations and oversight have paved the way for better care in many facilities. Most people view nursing facilities as a place for their loved one to live when they require 24 hour nursing care. Many do not know that almost all rehabilitation facilities currently have sub-acute rehab units that provide physical, occupational, and speech therapy following a hospitalization. This can be a great benefit to seniors who are not ready to return home. As well it serves to reduce re-hospitalizations.
Under the Medicare benefit, one is eligible for a total of 100 possible days for rehabilitation at a skilled nursing facility if they meet Medicare criteria and show continuous improvement. The first 20 days are covered at 100 percent by Medicare. Days 21-100 will have co-pay, unless you have a supplemental plan, which often would cover the copay. A three night hospital stay would also be required to access this skilled nursing and rehabilitation benefit.
Utilizing rehabilitation at a skilled nursing facility is beneficial to many seniors whom have been hospitalized and wish to return back home or to their senior living communities safely. The hospital provides acute rehabilitation which generally only lasts 7-14 days, but is often no more than a week. There are many situations that call for a longer recovery time requiring anywhere from 14-60 days of rehab. Many post stroke patients may require the full 100 days. Rehabilitation at a skilled nursing facility is generally provided 5-6 days a week. This is advantageous to those that require a longer recovery time and need the frequency and consistency of rehabilitation provided daily. Additionally the 24 hour care and supervision of nursing staff is an added benefit.
There are other rehabilitative services that Medicare covers following discharge from the hospital. However it is important to become informed about what the services entail whether it is the appropriate amount of care for the person’s needs. Home health, which is covered by Medicare, allows for therapists to come to the home or senior living community several days a week for therapy sessions, nursing visits, and assistance with showering. However, these visits are generally no more than an hour several days a week. Following surgery, or an extended hospital stay, many patients may require a higher level of care. Outpatient rehabilitation clinics may offer therapy 3-4 days a week but transportation to these clinics may be required. This may present a challenge for many seniors.
Some common reasons for admission to a skilled nursing and rehabilitation facility are: Recovery post-surgery, debility related to infections such as pneumonia and UTI, recovery from a stroke or TIA, and numerous other medical conditions that have caused a decline in physical or cognitive functioning. Utilizing this benefit can prevent falls leading to re-hospitalization. The rehabilitative goal is to help someone return to their prior level of functioning, if possible. If not, the therapists will work to set new goals, improve functional status, improve cognitive abilities, and make safe recommendations for discharge.
The hospital social worker or case manager will help with placement to a skilled nursing and rehabilitation facility. They may often recommend this as an option versus returning home with home health therapy or outpatient therapy. If this is not recommended, the patient may still want to discuss this option with their physician. Additionally www.medicare.gov can be accessed to utilize their nursing home compare function. The site rates all skilled nursing and rehabilitation facilities on the quality of their services. Touring the facility and meeting with staff to get an overall feel is also very important. All of the options discussed should be considered after being hospitalized. Utilizing the skilled nursing and rehab benefit can be vital in reducing hospitalizations and helping seniors return safely to their homes and communities.