How to Choose an Outpatient After-Surgery Rehab Center

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Five Star- FL

For more information about the author, click to view their website: Five Star Senior Living

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Aug 27, 2023

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Florida - Southwest

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When an older adult is hospitalized for an injury, illness or planned surgery, they may continue to recover at a skilled nursing and rehab center before returning home or to their senior living community. This short-term care can help improve their overall outcome and prevent a return trip to the hospital. But what about long-term? How does someone stay in their best physical shape—and out of the ER—as life goes on?

That’s where outpatient after-surgery rehab centers come in. Outpatient rehab is an option that can follow short-term rehab to provide more intensive therapy in an outpatient setting. This comprehensive approach can ensure a complete recovery and a more durable therapeutic outcome.

Not all outpatient rehab providers are alike, however. Try the tips below to find the best provider for you or your loved one.

6 Tips for Choosing an Outpatient Rehab Provider

Here are some factors to consider and questions to ask when exploring outpatient after surgery rehab center options:

  1. Success rates: Outpatient rehab providers have varying levels of experience. Make sure you ask a provider how well their clients do in the following areas: reduced risk of falling, increased walking distance and improved ability to use stairs. Can they provide figures? What percentage of clients end up back in the hospital?
  2. Specialization: Have the providers’ therapists completed specialized training in working with older adults? Do they use programs clinically proven for older adults, such as the Otago Exercise Program, which is designed to reduce risk of falling?
  3. Fitness training: Does the provider offer post-rehab fitness and strength training? This one-on-one personal training can help prevent future injuries and allow seniors to retain their highest degree of independence. Not many outpatient rehab providers offer fitness training, but its many benefits are worth the trouble to find one that does.
  4. Reputation: How long has the provider been in business? Longevity can be a mark of success. Also ask friends who have been through outpatient rehab what advice they have to offer. It can help you gain objective insight into any provider you are considering.
  5. Fully equipped onsite clinics. Is the provider located onsite or elsewhere? Offsite providers can’t carry in some of the sophisticated equipment needed for optimal outcomes, such as SCIFIT cardio equipment, recumbent bikes and HUR balance equipment.
  6. Scheduling: Does the provider offer onsite clinic hours so clients aren’t beholden to a visiting therapist’s schedule? The easier it is to schedule, the better the chances of completing a course of therapy or fitness training for a full return to optimal quality of life.

Respite Care: A Convenient Option for Outpatient Rehab

If you or a loved one are having surgery and anticipate the need for support from an after-surgery rehab center, here’s good news: You can book a short-term stay in a Five Star Senior Living community that features an onsite Ageility clinic. Ageility is Five Star’s rehab and fitness partner. Founded in 2001, Ageility specializes in older adults and provides fitness classes and training in addition to onsite physical and occupational therapy. Find out if there’s an Ageility clinic near you.

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Senior Rehab Center: How to Know When My Parent Needs It

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Consequences of Not Using a Medicare Set-Aside Account

Those who obtain a workers compensation settlement for future medical expenses must create a Medicare Set-Aside (MSA) Account to preserve their eligibility for Medicare. This separate, interest-bearing account pays for medical costs related to the workers injury. After the funds are exhausted, Medicare provides coverage for medical fees related to the injury.Why You Should Create an MSA AccountFailing to establish an MSA can have significant consequences for Medicare eligibility. Neglecting to create an MSA can result in losing Medicare, as well as means-tested government benefits like Medicaid. In certain cases, not using an MSA following a settlement can lead to liability.Keep Your Medicare CoverageIndividuals who receive settlements or judgments to cover future medical care must use these funds for that purpose to preserve Medicare coverage. For these expenses, Medicare is not the primary payer. Payments for the injury kick in only after the account is depleted and the beneficiary files a report with the Medicare Secondary Payer (MSP) Recovery Contractor. (Learn more about the Medicare Secondary Payer Act.)Receiving a settlement for future medical expenses without setting up an MSA jeopardizes Medicare eligibility. Someone who ignores the requirement to create an MSA could forfeit Medicare coverage entirely. This could mean losing coverage for all medical expenses, including those unrelated to the injury.If Medicare acts as the primary payer meaning that Medicare pays first when funds should have come from workers compensation, Medicare has a right of action. It can take legal action against the primary payer responsible for the payment, as well as those who received Medicares funds.When beneficiaries are unaware of the rules and fail to create an MSA, they could lose coverage.Stay Eligible for Public Benefits Programs With Asset LimitsNot having an MSA, or setting one up that is ineffective, can also make individuals ineligible for means-tested benefits such as Supplemental Security Income (SSI) and Medicaid.The Social Security Administration counts settlement funds as assets. Without a proper MSA, a person who acquires money to cover prospective medical costs following an accident could lose their public benefits.Increases in assets can also disqualify beneficiaries of the following programs:Supplemental Nutrition Assistance Program (SNAP)Temporary Assistance for Needy Families (TANF)Low-Income Home Energy Assistance Program (LIHEAP)People who obtain workers compensation settlements can continue to receive means-based benefits, along with Medicare, when they have a well-structured MSA. According to the Special Needs Alliance, embedding a special needs trust (SNT) within an MSA can allow a person to continue accessing government benefits. This is because the funds in an SNT are not countable assets.Avoid Liability After a Workers Compensation SettlementThe Centers for Medicaid and Medicare Services (CMS) requires that workers compensation settlements reasonably consider Medicares interests. A workers compensation settlement requires a person to create an MSA. If they fail to do so, they could face legal consequences for breaching their settlement agreement.CMS can also obtain restitution from anyone involved in the settlement, including the worker, workplace, insurance companies, and attorneys.Consult With a Special Needs Planning AttorneyCreating and maintaining an MSA can be complex. If you wish to keep your Medicare eligibility while receiving compensation for an injury, working with an attorney to help you set up and manage an MSA is critical.Consider consulting with a special needs planning attorney like Sharek Law Office. We can help you stay eligible for Medicare after acquiring a workers compensation settlement. Call our office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff to discuss your needs today. Learn More About MSAsFor more information about Medicare Set-Asides, check out the following articles:What Is a Medicare Set-Aside and When Do You Need One?What Happens When You Have a Medicare Set-Aside and Don't Need Treatment?What Happens If My Medicare Set-Aside Runs Out? This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.