Choosing the Right Rehab Facility

  • After a hospitalization, some older patients require rehabilitation before they can safely go home. There are two different types of rehabilitation: Acute and Subacute.

    • Acute rehab is intensive and is often hospital based or in free standing rehab facilities. It is generally approved for patients who were high functioning prior to hospitalization, can manage three hours of therapy a day and is intended for shorter periods of time – generally 1-2 weeks.

    • Sub-acute rehab (SNF) is often housed with a nursing home and is approved for patients who have skilled nursing and/or therapy needs, can do 1-2 hours of therapy a day and stays tend to be longer ~ three weeks on average. 

  • Medicare covers both, but approval depends on: 

    • Medical need 

    • Functional status 

    • Doctor or physical therapist recommendation 

    Medicare Part A covers subacute rehab in a Skilled Nursing Facility (SNF) after a 3-day inpatient hospital stay. Acute rehab is also covered but requires stricter qualifications. 

    Medicare Advantage plans may not be accepted by all rehabilitation facilities. Work with the discharge coordinator or speak with administrators in the facilities that interest you to see about in network facilities.

    If your loved one is being discharged from a hospital and you are not sure which type is best, ask for a physical therapy consult to help decide. 

    If your loved one was recently discharged home after spending at least 3 nights in the hospital and you think they actually should have gone to rehab, they may still qualify. If it is within 30 days of discharge, call the rehab facility that interests you and speak with the administrator about admission.

  • 1. Medicare Certification

    • Make sure the facility is Medicare-certified, especially if your loved one will be using Medicare Part A to cover rehab. 


    2. Quality of Rehab Services

    What therapy services are offered?

    • Physical therapy (PT) 

    • Occupational therapy (OT) 

    • Speech therapy 

    How often and how long are therapy sessions?

    • Look for at least 5 days a week, sometimes more in intensive rehab. 

    • Are therapies tailored to individual goals?

    • Ask how they set and review recovery milestones.  


    3. Medical & Nursing Care

    Is there a physician or nurse practitioner on-site every day?

    • How quickly will they be seen after arriving and how frequently thereafter 

    What’s the nurse-to-resident ratio?

    • How many skilled hours does each patient receive each day? 

    Can they manage your loved one’s specific needs?

    • Diabetes, wounds, stroke recovery, post-surgical care, etc. 


    4. Staff and Culture

    Observe how staff interact with patients and families—are they kind, attentive, responsive? 

    Ask: 

    • How long has staff been there? 

    • High turnover can be a red flag. 

    • Has there been a recent change in ownership? 

    Do they involve families in care planning and updates? 


    5. Cleanliness and Safety

    Visit in person if possible: 

    • Is it clean, odor-free, and well-lit? 

    • Is equipment up to date and in good condition? 

    • Are handrails and safety features in place? 

    Ask about infection control and fall prevention protocols. 


    6. Ratings and Reputation

    Check Medicare’s star ratings for: 

    • Overall quality 

    • Staffing 

    • Health inspections 

    • Quality measures (re-hospitalizations, improvement in mobility, etc.) 

    Read online reviews but also ask for word-of-mouth recommendations from doctors, case managers, or friends. 


    7. Comfort and Amenities

    • Are rooms private or shared? 

    • What are meal options like? Can dietary needs be met? 

    • Are there social or recreational activities for rehab patients? 

    • How’s the atmosphere—clinical or more home-like? 


    8. Communication and Family Involvement

    • Will you be involved in care conferences? 

    • How often will you be updated? 

    • Can you call or visit easily? 

    • Do they offer discharge planning and home transition help? 


    9. Financial Considerations

    Does Medicare fully cover the stay?

    • Part A covers the first 20 days without copays and then daily copays increase with a maximum 100 days

    • Medicare Advantage should have the same coverage but may require prior authorization and some SNFs may not take all plans 

    Are there any additional costs or private-pay upgrades? 

    If you have Medicare Advantage, Medicaid, or supplemental insurance, will they accept these as primary or secondary payment source? 


    Ask the hospital discharge planner or case manager for recommendations. They often know which facilities have the highest quality care and may have a preferred provider list to share.