The Short on Rehab

Author

Larchwood Inns and The PARC Skilled Nursing

For more information about the author, click to view their website: Larchwood Inns

Posted on

Jul 02, 2018

Book/Edition

Colorado - Western Slope

What is Post-Acute Rehabilitation? It is an inpatient center that provides therapies and/or Skilled Nursing.  Adults go there to recover from illness, injury, surgery, or other medical conditions following treatment in an Acute Care Hospital. Post-Acute Rehabilitation is a term used interchangeably with Short Term Rehab, Transitional Care Unit and Skilled Nursing Rehab Facility (SNF). These facilities offer similar services, such as: Physical Therapy, Occupational Therapy, Speech Therapy and Skilled Nursing Services. All centers have a Physician directing care and follow the same rules and regulations governed by Medicare. Not all Post-Acute Centers accept Medicaid and/or private insurance.

An individual’s Medicare benefits begin after a qualifying Acute Hospital stay if skilled services (Therapy and/or Nursing) are needed to regain physical health to go home safely. The first 20 days of Post-Acute Rehab is paid for by Medicare without a co-payment. Starting on day 21 there is a co-payment, and, depending on the individual’s circumstance, the co-payment is that person’s responsibility and may be paid by secondary insurance, by Medicaid, or by themselves.  It is important to remember that not all Post-Acute Rehabilitations Centers are licensed to take Medicaid. Bearing this in mind, when co-payments begin, they may have to transfer to another Rehab facility to continue their skilled rehab services.  (In extreme circumstances, Medicare stays can be as long as 100 days if the individual continues to qualify for skilled services.) Medicare Advantage plans must give pre-authorization for skilled services and will require re-authorization usually every 7 days throughout the Rehabilitation stay.  One important consideration between traditional Medicare and Medicare Advantage Plans is the decision that a person no longer needs skilled services based on Medicare regulations and their Rehab benefit will end. Traditional Medicare, the Rehab facility and their therapy and nursing team makes the determination and Medicare Advantage Plans after consideration of chart review will determine when it is no longer necessary.

Questions to ask:

·         Tour the facilities and take a family member and/or trusted friend with you. Look at the room, dining area, community rooms, and Therapy Facilities.

·         What insurances does the facility accept, and will the facility bill your private insurance?

·         Does the facility accept Medicaid? Very important if you may need extended Rehab.

·         Does the facility offer Physical, Occupational, and Speech Therapy? Do they have specialized equipment or services?

·         Ask about dining services and whether the facility is able to meet your individualized preferences. Ask to view a menu and you may even want to arrange to eat a meal.

·         What is the facilities Medicare quality (CMS) star rating?

·         Can the facility provide 1st medication dosing on site?

·         Do they bill secondary insurance?

·         What does the facility do to provide an individual plan of care that meets your discharge goals?

Editor’s note: This article was submitted by Melisa Latham, RN, NHA. Melissa is the Administrator at Larchwood Inns and the PARC and may be reached at 970-245-0022 or by email at MelissaL@LarchwoodInn.com.

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