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Choosing a Rehabilitation Provider

When you or a loved one suffer from an injury, surgery, or stroke, the path toward healing may extend beyond the halls of the hospital. During the discharge process, your doctor and treatment team may recommend continued care in a rehabilitation facility where therapists will provide you with targeted and intensive occupational, physical, and/or speech therapy exercises. These exercises give you the best chance of recovery and independence possible. As you prepare to leave acute care, your hospital treatment team will recommend two options for rehabilitation: an inpatient rehabilitation hospital (IRH) or a skilled nursing facility (SNF). While both treatment providers offer different levels of care, expertise, and knowledge, finding the right support can make all the difference in your recovery. Below, the Reunion team is answering frequently asked questions among patients evaluating their options for rehabilitative care.

1. Will Medicare cover my rehabilitation stay?

Medicare can dramatically reduce your family’s financial responsibility for rehabilitative care by covering eligible stays. While SNFs require a three-day, pre-qualifying hospital stay for coverage, IRHs do not. Generally, Medicare will pay for 90 days of treatment for patients who choose to recover in an IRH, fully covering the first 60 days of care. Alternatively, Medicare will pay for 100 days of treatment for patients who choose to recover in an SNF, fully covering the first 20 days of care.

2. Who provides care in an SNF? In an IRH?

In SNFs, nursing assistants who have received extensive classroom and clinical training in state-certified nursing assistant programs provide patients 24/7 care under the supervision of LPNs and RNs. In IRHs, registered nurses (RNs) who have earned an associate’s or bachelor’s degree and passed the national licensing examination in nursing (the NCLEX-RN) provide patients 24/7 care. Many registered nurses who work in IRHs also specialize and are certified in rehabilitation nursing.

3. How often do the treatment teams at SNFs and IRHs meet to discuss patient care?

While both IRHs and SNFs hold weekly team meetings to discuss every patient’s care and progress, IRHs alone include a coordinated interdisciplinary group at these meetings. Led by rehabilitation physicians, these groups often include therapists, nurses, and a patient’s family members. Because the IRH is only one component of recovery, these meetings give families an opportunity to speak with the team about ongoing patient support.

4. How often will I receive therapy and who provides it?

In IRHs, registered physical and occupational therapists will provide you with rehab therapy, three to five hours a day. In SNFs, physical therapy assistants and certified occupational therapy assistants will provide you with therapy from one to two hours per day.

5. What is the average length of stay for patients at each type of facility?

Patients typically remain in IRH care from 12 to 16 days. Due to a less intensive therapy schedule, patients usually remain in SNF care from 24 to 60 days.

6. Will the facility have access to multiple physician groups involved in my care (i.e., nephrologists, neurologists, cardiologists, and neuropsychologists)?

IRH patients have access to physicians in multiple groups on a full-time basis; at SNFs, access to these groups is typically limited.

7. How do IRHs and SNFs measure the effectiveness of their rehabilitation program?

IRHs measure their effectiveness through quality assurance and utilization reviews. These reviews ensure that each and every facility provides each and every patient the best possible care and rehabilitative support. SNFs have no measures for quality assurance or utilization reviews.

After talking through the questions above with your care team, family, and loved ones, we hope that you are one step closer to determining the best care plan for your long-term recovery. While both IRHs and SNFs can help you meet your recovery goals, one study has shown that clinically and demographically similar patients who received their post-acute rehabilitation at an IRH lived longer, left the hospital sooner, and required emergency room care less frequently than clinically and demographically similar patients who received care in an SNF.

At Reunion Rehabilitation Hospital, we provide inpatient rehabilitative care at state-of-the-art facilities because we believe that all patients should spend less time worrying about their health in the ER , and more time with the friends, family, and loved ones outside of treatment who make their lives so special.

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