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 facility is for. Luckily, here in Cincinnati, we have several top-notch facilities (including Episcopal Retirement Services’ Marjorie P. Lee retirement home) which serve the needs of physical rehab patients.
But how do you go about choosing which short-term rehab facility is right for your elderly loved one? The vast majority of patients and their families get caught unaware when they need physical rehab — they’ve never considered the possibility of needing it before, so they haven’t researched facilities beforehand and have no idea how to start.
In fact, according to research cited by Reuters, 83 percent of people who need to find a short-term rehab facility for a recovering loved one cannot name a single provider. They have no reference points to begin their search and often make snap, sometimes ill-advised transfer decisions under pressure from care managers at acute care hospitals who need to discharge patients to open 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 the well-being of your parent, don’t just consider cost. Health outcomes, wellness programs, presence of on-site clinical staff, happiness of the residents, the number of activities available, location and condition of the facility all need to factor into your process.
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 in advance and proactively visiting facilities with them 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 needing to make 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 pre-certification required to ensure coverage?
Traditional Medicare will only cover the first 20 days of a short-term rehab stay at 100 percent following what’s called a “qualifying hospitalization event.” After that, it will charge a $152 daily co-pay for the next 80 days.
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 transfer.
2. Are there separate wards 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 facility staffs 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 (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?
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 also encourage you to come tour Episcopal Retirement Services facilities, like Marjorie P. Lee, and see the difference in care that we can offer your family.