Skilled Nursing Facility vs. Rehab Center: How to Choose

By Angelike GauntSeptember 10, 2020

Many older adults need rehabilitation services after a hospital stay. Whether your elderly loved one is recovering from an illness, injury, stroke, or surgery, rehab can help them regain strength and mobility. It can also improve physical and cognitive function.

When it comes to choosing where to complete rehab, families have options. So how do you choose between a skilled nursing facility and inpatient rehab center? Both skilled nursing facilities and rehab centers aim to help seniors recover and restore function so they can return to normal activities and live as independently as possible. They also provide many of the same rehab services, but the intensity of programs offered may differ.

It’s important to understand the differences between these two rehab options and to discuss their benefits with a doctor to make the right decision for your loved one.

What is a skilled nursing facility?

There are many reasons seniors need rehab services — a fractured hip, stroke, pneumonia, or heart disease are just a few. Skilled nursing facilities provide short-term, temporary housing; 24-hour skilled nursing services; and medical care to elderly adults who need rehab after a hospital discharge.

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Rehab services at a skilled nursing facility may include:

Physical therapy
Occupational therapy
Speech therapy
Social and psychological services
Orthopedic rehabilitation

Elderly adults at skilled nursing facilities receive therapies for an average of one to two hours a day. They also receive personal care and help with activities of daily living, such as eating, bathing, and walking.

Staff at these facilities include certified nursing assistants; licensed practical nurses; registered nurses; and physical, occupational, and speech therapists, among other specialists. Once staff evaluate your loved one’s health and rehab goals, they’ll develop a care plan. The plan outlines the type of rehab services your family member needs and how often they’ll receive them.

Rehab at a skilled nursing facility may be partially or fully covered by Medicare, depending on how long your parent needs rehab care. Medicare coverage may include a shared room, meals, medications, skilled nursing care, different types of therapies, and more. In order to be eligible for Medicare coverage, your loved one must enter the facility within 30 days of being discharged after a hospital stay that lasted at least three days.

What is an inpatient rehab center?

Inpatient rehab is offered at special hospital units dedicated to rehabilitation services. The same rehab services offered at skilled nursing facilities are provided at inpatient rehab centers, including nursing care; orthopedic rehabilitation; physical, occupational, and speech therapy, and more. However, programs at inpatient rehab centers focus on acute care for elderly adults who need more intensive treatment and recovery.

Seniors who have had a stroke, traumatic injuries, surgeries, and amputations may need intensive, daily therapy for a successful recovery. Rehab centers offer a minimum of three hours of therapies daily, six days a week, to promote fast, but safe, recovery.

Older adults who complete rehab at inpatient rehab centers often have shorter stays than those who choose rehab at skilled nursing facilities. A typical stay at a rehab center ranges from 10 to 35 days. Stays of 24 to 60 days are common at skilled nursing facilities.

As in skilled nursing facilities, inpatient rehab centers offer meals, personal care, and assistance with daily activities.

Rehab at an inpatient rehab center may be covered by Medicare, but your parent may need to pay a deductible. Medicare coverage may include shared rooms, meals, medications, nursing care, and different therapies.

How do you choose between skilled nursing and rehab?

When choosing the right rehab option for your senior loved one, it’s important to discuss rehab goals and needs with their doctor.

Here are a few important factors to consider:

Program intensity. Programs at skilled nursing facilities and rehab centers differ in intensity. Talk to the doctor about the types of therapies your parent will need and how often they’ll need these services.
Length of stay. Is your family member motivated and determined to return home as soon as possible? More intensive therapies at a rehab center often mean a shorter stay at the rehab facility.
Access to physicians and specialists. Elderly adults who have complex rehabilitation needs may benefit from daily access to a physician and different specialists at an inpatient rehab center. In contrast, those at skilled nursing facilities typically see a physician one to three times a week.

Inpatient rehab centers often rely on registered nurses who specialize in rehabilitative services. Skilled nursing staff usually consist of nursing assistants certified in long-term care who are supervised by a licensed practical nurse or registered nurse.
Costs and coverage. While your loved one may be eligible for full or partial Medicare coverage in either a skilled nursing facility or rehab center, they may need to pay a deductible if choosing inpatient rehab.

Skilled nursing facility vs. rehab centers at a glance

Top considerationsSkilled Nursing FacilityInpatient Rehab CareProgram intensity1 to 2 hours of daily therapyAt least 3 hours of daily therapyAverage length of stay24 to 60 days10 to 35 daysAccess to physiciansPhysician visits 1 to 3 times a weekDaily physician visitsStaffingNursing assistants certified in long-term care who are supervised by registered nurses or licensed practical nursesRegistered nurses who specialize in rehabilitative careCosts and Medicare coverageMay be completely or partially covered by Medicare, depending on multiple factors, including length of stayMay be partially covered, depending on facility; may require a deductible

Sources:

Medicare.gov. Inpatient hospital care.
https://www.medicare.gov/coverage/inpatient-hospital-care.

Medicare.gov. Skilled nursing facility (SNF) care.
https://www.medicare.gov/coverage/skilled-nursing-facility-snf-care.

Author

Angelike Gaunt

Angelike Gaunt is a content strategist at A Place for Mom. She’s developed health content for consumers and medical professionals at major health care organizations, including Mayo Clinic, the American Academy of Family Physicians, and the University of Kansas Health System. She’s passionate about developing accessible content to simplify complex health topics.