After an accident, illness, injury or surgery, your doctor may recommend that you spend time in a rehabilitation center to strengthen your body and enable you to return to your normal way of life. Two types of rehabilitation centers are available for older adults (typically those age 55+), Hospital Inpatient Rehabilitation and Skilled Rehabilitation Services. Both provide the same clinical care and rehabilitative therapy for recovery, but they can have vastly different schedules and timeframes for your rehabilitation, as well as vastly different physical environments. How do you know what is best for you? Let’s start by defining “Inpatient Rehab” and “Skilled Rehab.”
Defining “Inpatient Rehab” and “Skilled Rehab”
Your insurance company uses the term “Inpatient Rehab” when referring to short-term rehabilitation in a hospital setting that requires 3-4 hours of rehabilitation beginning on the day of admission (acute = intense). Your insurance company uses the term “Skilled Rehab” when referring to short-term rehabilitation in a community (like Fair Haven in Birmingham, AL) which provides skilled nursing care outside a hospital setting with rehabilitation that can be tailored to the intensity needs and capabilities of a patient (sub-acute = less intense).
What is the same?
With both Inpatient Rehab and Skilled Rehab, you can expect Physical Therapy, Occupational Therapy and Speech Therapy available to you six to seven days a week, in most cases. Both providers can include a regimen intensive rehabilitation of 3+ hours per day beginning at admission. In addition, 24-hour RN coverage, wound care, and IV antibiotics are usually available. Both will have discharge planning services to assist with the transition to home or to another level of care.
What is different?
Tolerating the Rehabilitation
For Inpatient Rehab in a hospital setting, a patient must be able to tolerate 3-4 hours of rehabilitation each day immediately upon admission. In a Skilled Rehab setting, the patient can start with a less intense therapy regimen and gradually increase therapy tolerance, essentially completing their rehabilitation program at their own pace.
Timeframe for Rehabilitation
An Inpatient Rehab center may mandate the patient be discharged in 2-3 weeks. In a Skilled Rehab community, rehabilitation can be expanded up to 100 days, based on patient participation in the therapy regimen and the approval of the insurance provider.
Transition for Continuing Recovery Needs
Hospital Rehab centers will only allow a small percentage of its patients to be discharged to a Skilled Nursing Center where further rehabilitation can take place. Skilled Rehab centers do not have this limitation. Patients in a Skilled Rehab center who need continued care and therapy are able to transition to the additional care they need.
The Physical Environment – The Household Model Difference
Hospital Rehab centers typically look and feel like a continuation of the hospital, where the physical environment, services and routines are familiar. You’ll find central nurse’s stations, rooms arranged down long corridors with constant foot traffic moving along them, meals delivered from a central kitchen, and so forth. Scheduling of therapy sessions and care routines may largely be a function of staff convenience.
As the long-term care community looks at the desires of older adults today, some Skilled Rehab centers have chosen to build their rehabilitation centers to look like a home, like Fair Haven in Birmingham, AL. This innovative model of care is called the “Household Model.” In the Household Model, the central nurse’s station has been eliminated, opening up valuable space for the patients to enjoy, such as a shared living room, a kitchen, a family dining room and more. There is little foot traffic as the private suites are arranged down shorter residential-like areas. Meals are served right out of the household kitchen. Staff and resident relationships function much like a family. Scheduling of therapy sessions and other activities are largely driven by each patient’s preferences.
Making a Choice
Fortunately, most doctors and insurance companies will honor the patient’s choice of rehabilitation centers for their recovery. If you know in advance that you may need rehabilitation following an inpatient hospital procedure, take the time to tour a few rehabilitation centers so that you can see what is available to you. Then communicate your choice!
For more information about Fair Haven’s Skilled Rehab Center utilizing the Household Model, contact our admissions team at 205-956-4150, or send an email to Traci Kennedy at [email protected].