Even under the best of circumstances a hospital stay and/or rehab stay can be challenging, especially when returning home. What was once a normal part of the day – bathing, cleaning, cooking, doing errands, moving around the home, walking the dog – can be temporarily or permanently affected.
For some, facility-based care may be the only option due to the increased level of care required. The thing is, just about everyone wants to and age in place. Sometimes in order to return home, major changes will have to be made.
Planning for what comes next should begin as soon as possible (not at the time of discharge). While in the hospital, and in a rehab facility, you will have access to resources that are much harder (if not impossible) to utilize once you go home. Be sure to make the most of these resources. This guide is for a patient or their loved ones to help plan and consider the questions they should be asking:
Questions for the hospital’s team and for your loved one’s primary physician:
Questions for the hospital discharge manager or social worker
Before your loved one is transferred to a rehab facility
The transfer from hospital to rehab
After your loved one enters rehab
How much of my loved one’s rehab stay does Medicare cover?
Medicare does not typically cover long-term care in a rehab facility unless there are extenuating circumstances. Medicare recipients must first be in a hospital for a minimum of three nights, and receive a doctor’s order, to have Medicare cover care in a skilled nursing/rehabilitation facility. Medicare will pay for your loved one’s stay at a rehab center if they continue to benefit from receiving skilled services. If the patient has reached a level of mobility or health equal to their baseline health condition before the event that sent them to the hospital, Medicare typically will not continue to cover skilled nursing or rehabilitation services within the facility.
Families whose loved ones have their short-term Medicare benefits expire have three choices:
Adjusting to the “new normal” is never easy. Bringing a “stranger” in to provide home care can put additional strain (at least initially) on both the elderly loved one and her family.
Here are ways you can help ease the transition:
Making the transition from hospital to rehabilitation to home care can be extremely challenging, especially if the health, mobility, and mental state of your loved one have changed profoundly. Through the process, remember:
Dont forget you are not alone. Abby Services is here to help. Just call to speak with our RN who can help answer questions and guide you down the best path. 239-590-0861