How to Choose a Skilled Nursing Facility for Rehab Placement For Elderly Seniors and Geriatric Patients Leaving Acute Care Hospitals?

How to Choose a Skilled Nursing Facility for Rehab Placement For Elderly Seniors and Geriatric Patients Leaving Acute Care Hospitals?

When a senior is finishing up a stint at an acute hospital for surgery, injury, or illness. A simple transition home may not be the only route in consideration for discharge.

If a senior patient lacks the support for safe and effective rehabilitation at home, then medical staff may recommend that he/she transfer to a skilled nursing facility for short-term rehabilitation.

With this in mind, let’s talk about what seniors and their family members should consider before selecting a skilled nursing facility.

Instead of just going along with the first facility that a doctor may recommend, explore some of the following questions so that you can still have the elements of choice and control:

Is The Facility Covered By Your Insurance?

Before setting your heart and mind on one facility, make sure that the room, board, and healthcare services provided are actually covered by your health insurance.

Overnight rehab stays are expensive and can quickly add up in out-of-pocket costs, so save yourself the trouble and clear the facility with your insurance company. 

How Long Is The Rehabilitation Stay?

Do some research about expected rehabilitative stays for your medical condition. Basic examples include expected stays for post-operative conditions such as knee, shoulder, and hip replacements.

Post-surgical conditions are usually more predictable than other conditions if absent of other medical complications.

However, in many incidences the patient will not know how long for sure they will be staying at the facility until determined by the rehab team onsite.

What Are The Admission Criteria or Level of Functional Decline Required for Admission?

New patients will undergo a series of assessments to determine whether they qualify for skilled nursing and rehab admittance or not.

Scores are calculated using assist levels for activities of daily living. One example may be “the patient requires moderate (50%) assist from others to complete toileting tasks”.

If a senior is unable to complete a certain number of daily living tasks independently and safely, then they will most likely qualify for rehab stay.

What Services Does The Facility Offer?

Check out the facility website and go as far as to request a tour of the building. Find out about what types of services are included in the rehab stay package.

Most facilities in the United States offer all or a combination of some of the following: social services, physical therapy, occupational therapy, speech therapy, recreational therapy, nursing care, respiratory therapy, housecleaning and laundry, wound care, and nutrition.

Research the extracurricular services that may be available (salon services, religious meetings, game nights, etc.).

What Safety Protocols Are in Place at The Facility and Actively Practiced?

Interview admissions staff and ask detailed questions about safety protocols carried out at the facility.

Talk about whether the facility is well-staffed or not to carry out the protocols and which ones: fall risk and safety, infection control, pressure-relieving schedules, skin and wound care, building security and after-hours access, etc.

Given recent events, it is also important to talk about protocols for COVID-19 (i.e. visitation rules, contact precautions, infection control, etc.).

 What Are The Facility Protocols In The Event of Illness or Worsening Conditions?

If a senior falls ill, gets injured, or experiences worsening medical conditions, each facility has a system to determine when and where the patient goes from there.

Ask about how the patient is monitored, what signs indicate that the patient needs to be sent back to the hospital, and how informed the staff keeps family members on the patients’ status.

What is The Rehabilitation Department Like? How Often Will I Get Physical, Occupational and Speech Therapy and for How Long?

Since rehab is a major reason for the stay, patients should research and tour the rehabilitation department.

Check out the gym and the exercise equipment available for therapeutic use.

Ask about therapy services (i.e. occupational, physical, and speech) and how often patients receive services.

What Current Online Reviews Are Available About the Facility?

As unpleasant as it can be, take to the internet and read reviews about the facility from past patients, family members, and caregivers.

Read through both the good and the bad reviews to determine whether or not the facility would be a good fit for you.

What Are the Visitation Rules at the Rehab or Skilled Nursing Care Facility?

Ask admissions staff about rules for visitation. Talk about the visitation hours available and about check-in processes.

In recent months, visitation rules have been constantly evolving with the pandemic so know that the regulations are subject to change from day to day.

What Transportation Services are Available for Out-of-Facility Appointments like Dialysis?

For follow-up doctor appointments, surgical procedures and testing, and regular dialysis, patients will need reliable transportation services to get to and from the facility.

Ask about the transportation staff, the process of scheduling transport, and the process of being dropped off safely at the facility and at other medical buildings.

What is The Process For Plan-of-Care and Goal Development Like? How Often Will the Facility Involve the Senior and Family Members in Discharge Planning?

Finally, check with the interdisciplinary team about what plan-of-care development looks like and how involved the patients and family members are in the process.

You want to stay at a facility that puts the patients’ needs and goals first so that you are getting the fullest rehab benefit and getting home in a timely fashion.

Ask about how regularly the team meets to update goals and to keep the rehab process moving forward.

Transitioning from a hospital to a skilled nursing facility can be emotional and stressful, especially if it wasn’t the original plan to begin with.

Seniors and their family members can be better prepared for the transition if they proactively research potential facilities.

Thanks to the internet world, we all have immediate access to intimate details about skilled nursing so that we can make our own decisions about our healthcare needs.

Don’t be afraid to ask the hard questions and to thoroughly investigate each facility before settling on one for an extended stay.

Author: Samuel

Samuel is a physical therapist with over 20 years medical experience. He has extensive knowledge in functional rehabilitation in the acute care hospital and in-home care settings. He has spent most of his career helping seniors transition from hospital or rehab care to living independently at home. In his free time he likes to travel and read autobiographies.

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