Maybe you’re having back or neck surgery to correct years of damage and chronic pain. Or you have an upcoming, elective knee or hip replacement surgery. Or you’re slowly mending in the hospital after having been seriously ill or injured.
And your doctor has informed you that, to continue your recovery and regain your strength, you’ll need a stay in a skilled nursing care center for short-term rehabilitation before you can safely return home.
What do you do? How do you find the short-term rehab center in Cincinnati that would be right for you? Who should you entrust with your care? What criteria should you use to decide?
We’re here to help you make that choice. Here’s a checklist you can use to choose qualified, safe providers of short-term rehab services:
____ Does the short-term rehab facility accept your insurance?
This is probably the first question you should ask. If a skilled nursing care center doesn’t accept your insurance, you could be facing a large bill.
____ Does your insurance company require pre-certification for your stay?
If the short-term rehab center accepts your plan, you should next call your insurance company to find out if your stay will need to be pre-certified for it to be covered.
____ Will your insurance cover all, or part, of your stay?
Remember, a provider’s acceptance of your insurance doesn’t mean you won’t be receiving a bill. You need to check your plan to see how much is covered. Will there be a co-pay or shared responsibility payment due at admittance? What is your deductible? Does your plan put a coverage cap on length of stay?
Under traditional Medicare, for example, only the first 20 days of a short-term rehab stay following what’s called a “qualifying hospitalization event” are covered at 100 percent. After that, for the next 80 inpatient days, Medicare charges you a $152 daily co-pay.
____ Will you be able to afford the projected after-insurance costs?
It can be hard to anticipate what will be the total cost of your stay in a short-term rehab; much depends on how fast and how well your body heals. Some of that will depend on how dedicated you are to following your therapy regimen.
But the short-term rehab provider should be able to give you a ballpark estimate, based on its experiences treating patients with similar conditions, how long your stay would likely run, and what the out-of-pocket cost of such a stay might be after your insurance pays its share.
____ Have you checked the provider’s accreditation and safety record?
Skilled nursing care centers and short-term rehabilitation providers — like Episcopal Retirement Services’ Marjorie P. Lee community — must undergo a rigorous set of annual safety inspections and accreditation processes.
Before you choose a provider, check out its accreditation status with the Joint Commission (JCAHO) and with the Commission on Accreditation of Healthcare Organizations (CARF).
You should also review the provider’s Centers for Medicaid & Medicare Services’ (CMS) Nursing Home Compare rating.
____ Does this SNF pass the “sniff” test?
Visit any given inpatient facility and you will, at some point, smell something unpleasant. That’s just a fact of life in healthcare.
But if, when you visit a short-term rehab provider, you smell unpleasant odors in the hallways or in the presence of residents, there’s a good chance the staff is overwhelmed, poorly trained or neglectful.
____ Is the interior cheery, with plenty of natural light?
No one wants to recover in a dungeon. Do the hallways have dingy walls, dull tiles and fluorescent lighting? Or are they clean, wide, brightly painted and sky-lit?
Are the common areas spotlessly clean? How about the restrooms: sanitized and well-stocked, or needing attention?
____ Are the grounds well-kept?
A skilled nursing community that takes care of the appearance of its exterior is more likely to care about the cleanliness of its interior.
____ Is the care center secure?
Are the entrances all well-lit and secured? Are the grounds and hallways patrolled regularly by a qualified, caring security staff? Do you see any residents who look like they’re confused, lost or wandering unsupervised?
____ What’s the patient-to-staff ratio, and how long are nursing shifts?
The lower the numbers, the better. Lower patient-to-staff ratios and nursing shifts of reasonable duration have been strongly correlated with lower patient fall rates, lower medical error rates, quicker recovery times and positive health outcomes.
____ Is an attending physician on site 24/7? If not, is one always on call?
The more readily available the facility’s attending physician is, the closer you’ll be to qualified medical decision-making should an emergent or serious complication occur.
____ Is there a specialized ward for short-term rehabilitation care?
Many short-term rehabilitation providers are also long-term skilled nursing facilities. One hallmark of strong rehab care is specialization among the staff.
The needs of a patient recovering from pneumonia are different from the needs of someone re-learning to walk following a fall injury, stroke or major surgery. And short-term rehab patients’ needs are very different from those of long-term or permanently-placed residents.
If there’s only one set of staffers trying to meet everyone’s care requirements, the quality of care might suffer. If the facility staffs specialists for each area, and they’re proactively monitoring the patients, the care may be of better quality.
____ What therapies are available on-site?
Does the short-term rehab center offer physical (PT), occupational (OT), respiratory (RT) and cognitive therapies? How about cardiac rehab services? Does it have a fitness center and hydrotherapy pool? How about more holistic rehab services, like massage and yoga?
Or, for some therapies, must the short-term rehab provider send residents to other facilities? Are RTs available on-site, 24/7, to perform emergency interventions?
____ If you’ll need to travel off-site for additional therapies or doctor appointments during your stay, will the center provide transportation?
This is especially important if your insurance plan doesn’t cover medical transportation, or if you don’t have a partner, family members, or friends in the area who can take you to your follow-up appointments.
____ Will the short-term rehab center provide, or help you to arrange, follow-on outpatient care?
Will you have to source your own outpatient care? Or, are in-home PT and OT visits included in your post-discharge care plan?
If you’ll require ongoing in-home nursing, personal assistance, or community-based services like Meals on Wheels deliveries, does the short-term rehab also provide those, or can it help you to arrange them?
____ How’s the food?
On your visit, ask the current residents and patients. Better yet, sample it yourself. Don’t accept a provider that doesn’t provide delicious and nutritious meals for its residents.
____ When you visit, do patients, residents and staff seem happy and engaged with their surroundings?
When you visit a short-term rehab center, observe the people currently undergoing care. Do they seem “with it?” Do they socialize with the staff and with each other? Are people friendly? Or do they seem miserable?
Do the nurses seem to congregate too much at the nurses’ station? Are they checking Facebook on their computers and texting on their cell phones, or are they checking in on their patients most of the time?
____ What are the short-term rehab’s visitation policies? Is it in a convenient location?
Are visiting hours and the facility’s location convenient for your family and friends to pop in, check on you and cheer you up?
____ Will there be fun activities and amenities to enjoy?
Will there be more for you to do between your therapy sessions than watch TV in your room? Are there common areas to enjoy? Game nights? Movie nights? Special, themed dinner events? Group outings?
No one wants to have to spend more time away from home, recovering. But, if your doctor has told you that you’ll need a short-term rehab stay, we can help.
The staff at Marjorie P. Lee will make the road back to good health as smooth and pleasant as possible for you. Our community is top-rated, spotlessly clean, and cheery. And our safety record is unparalleled. We don’t just hope for good outcomes — we do everything possible to ensure them.
Want to see for yourself whether Marjorie P. Lee would be the right choice for your recovery? Schedule your tour today.