What happens when an older parent or loved one is discharged from the hospital while recovering from an injury, surgery, or illness but isn’t well enough to recover at home? What happens when he or she needs a temporary stay in a rehabilitation center to recover strength?
That’s what a short-term rehab center is for. Here in Cincinnati, we are fortunate to have several top-notch facilities — such as Lee Gardens and the Meyer Family Rehabilitation Center at Marjorie P. Lee — that serve rehab patients’ needs.
But how do you go about choosing which facility is right for your elderly loved one? The vast majority of patients and their families get caught unaware when they need short-term rehab — they’ve never considered the possibility of needing it before, so they haven’t researched options beforehand and have no idea how to start.
In fact, according to research cited by Reuters in 2014, 96% of survey respondents between the ages of 60 and 75 weren’t expecting to have surgery or sustain an injury over the next year. However, if circumstances were to change, 83% said they couldn’t name a single short-term rehab provider.
Seniors and caregivers alike often don’t have any frame of reference to begin their search and make snap, sometimes ill-advised transfer decisions under pressure from care managers at acute care hospitals who need to discharge patients to free up beds. Sometimes, caregivers are handed a list of providers and forced to choose nearly at random.
How to Choose the Right Short-Term Rehab Provider
When it comes to your parent’s wellbeing, don’t just consider the cost. Health outcomes, wellness programs, presence of on-site clinical staff, the happiness of the residents, the number of activities available, location, and condition of the center all need to factor into your search.
You also need to consider your loved one’s wishes. If you can, it’s best to have a care plan in place before your family ever needs to consider providers. Talking with your older parents or grandparents and visiting facilities with them in advance can save you a lot of agonizing decision-making later on.
Realistically, though, not every family will have the luxury of forethought and planning before making a care decision. If an unexpected need comes up and you find yourself making quick decisions on someone’s behalf, you should at least have an idea of how to conduct your search for a provider.
Let’s review five questions you should ask during your search so that you can be sure you're choosing the right short-term rehab facility for your loved one.
1. Is my loved one’s insurance accepted and is precertification required to ensure coverage?
For Medicare Part A to cover your loved one’s rehab, they must first meet their Part A deductible. In 2020, the Medicare Part A deductible is $1,408 per benefit period. Medicare will then cover their stay in full for the first 60 days. If they continue receiving inpatient care after 60 days, they will be responsible for a coinsurance payment of $352 per day until day 90. On day 91, they will begin to tap into their “lifetime reserve days,” which requires a daily coinsurance of $704. Medicare offers a total of 60 lifetime reserve days. After those 60 days, they will be responsible for all healthcare costs.
Private insurance plans, or privatized Medicare and Medicaid HMO / PPO supplements, may cover short-term rehab stays to various degrees and charging variable co-pay amounts, but they may limit you to a certain list of in-network providers and may require pre-certification for eligibility. Make sure you check with your relative’s insurance provider before arranging the transfer.
2. Are there separate centers or staff teams for short-term and long-term rehab care?
One hallmark of strong rehab care is specialization among the staff. The needs of a patient recovering from pneumonia are very 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, such as dementia patients who require long-term admittance for memory care.
If there is only one set of staffers trying to meet everyone’s care requirements, care may suffer due to overwork. But if the care center provides specialists for each area and they are proactively monitoring the patients, care may be of better quality.
3. What is the ratio of staff members to patients?
The more people there are to work with and monitor patients, the safer a facility likely is. Watch, too, to see if staff members are actively monitoring patients’ wellbeing (i.e., checking on their charges at regular intervals) or merely responding to call buttons.
4. What therapies are available on site?
Does the facility feature physical, occupational, respiratory and cognitive therapy on the premises? Does it have a hydrotherapy pool and massage? Or does it send residents out to other facilities for therapy sessions? Are PT, OT and respiratory teams available 24/7 on-site for immediate intervention needs? Answering these questions will ensure the facility has the treatment options your loved one needs.
5. What happens after your loved one’s discharge from inpatient rehab?
Short-term rehab patients often need additional services even after they return home. Can the rehab facility provider help you and your loved one to set up and coordinate in-home care and outpatient therapy sessions? Does the provider provide those services itself?
There are many questions you should ask before agreeing to a transfer.
Do your research and try to get information in advance of meetings with your older loved one’s clinical team. Take the opportunity, if you can, to discuss with your parent his or her preferences before decisions need to be made. Encourage them to write those preferences down, either in a care management plan or in a living will document.
As always, we at ERS also encourage you to tour our short-term rehab facilities, like Lee Gardens and the Meyer Family Rehabilitation Center at Marjorie P. Lee, and see the difference in care that we can offer your family. We are also proud to announce that Dexur recently named our community among the top ranked nursing homes for the lowest length of stay for hip and knee replacement patients and best discharge to home rate in Ohio.
If you have questions about these rankings or want to learn more about our short-term rehab services, fill out our information request form.
Editor's Note: This blog was originally on May 11, 2016, but has been updated to reflect 2020 Medicare guidelines, new short-term rehab services available at Marjorie P. Lee, and Marjorie P. Lee's ranking on Dexur's top-ranked nursing home's list.