Rochester Senior AdvisorWhat is the difference between short-term rehab and long-term nursing care?
Short-term rehab is skilled nursing and therapy after a hospital stay with the goal of going home, usually paid by Medicare for a limited time, while long-term nursing care is ongoing 24-hour care for someone who cannot safely live elsewhere, paid privately or by Medicaid.
Most Rochester-area nursing homes offer both, often on separate units. Ask which unit a parent would be on and whether a move between them changes the room.
How long does Medicare pay for rehab?
Original Medicare pays for up to 100 days per benefit period after a qualifying three-day inpatient stay, in full for the first 20 days and with daily coinsurance after that, but only while the patient still needs and benefits from skilled care.
Most rehab stays end well before day 100. When the home issues a notice that Medicare coverage is ending, the patient can request a fast appeal through the Quality Improvement Organization named on the notice.
What happens if a parent cannot go home after rehab?
The family then chooses between paying privately for a long-term stay, applying for Medicaid, moving to assisted living if the parent's needs allow, or arranging home care, and the nursing home's social worker helps plan the transition.
If Medicaid will be needed, start the application early, since it requires five years of financial records. A Medicaid-certified home may not discharge a resident simply because the payment source changes to Medicaid.
How should I choose a rehab facility after a Rochester hospital stay?
Compare CMS's quality measures for short-stay residents, staffing hours and the latest inspection results for the homes the hospital offers, and choose one close enough for family to visit, since therapy goes better with family involvement.
Hospitals must give a list of options and may not choose for you. Our nursing home directory sorts every certified home in the five counties by CMS rating and staffing.
Does long-term care insurance pay for rehab?
Usually not while Medicare is paying for skilled care, but a long-term care policy may start paying once the stay becomes custodial, after its elimination period, if the policy's benefit triggers are met.
Call the insurer as soon as a stay begins, because the elimination period often starts counting from the first day of care.
At a glance
| Short-term rehab | Long-term nursing care | |
|---|---|---|
| Goal | Return home or to assisted living | Ongoing 24-hour care |
| Payment | Medicare, up to 100 days | Private pay or Medicaid |
| Length | Usually weeks | Months or years |
| Ratings to read | CMS short-stay quality measures | CMS long-stay measures and staffing |
Sources include the N.Y. Social Services Law and Public Health Law, 18 NYCRR Parts 487-494, 10 NYCRR Parts 415 and 1001, Department of Health GIS messages, CMS, the VA and CareScout, as cited above; see our editorial standards.
