Subacute Rehabilitation Care – You Can Change Facilities

I have frequently encountered the question, “can I switch to a different facility to continue my rehab?” I don’t know where the notion came from, but it appears that people believe that once they begin their post-hospitalization rehab under Medicare Part A, they have to stay there for the duration of therapy.

Medicare Part A pays for services rendered in a skilled nursing facility (SNF) for patients who (a) were admitted to a hospital for three or more consecutive days, (b) were admitted to the SNF within a short time (less than a month is the general rule), (c) requires daily skilled rehabilitation or skilled nursing services for a condition that was treated in the hospital (or arose while in the SNF) and (d) whose physician has certified to the above needs. http://www.law.cornell.edu/cfr/text/42/409.30 For up to 20 days, Medicare part A will pay 100% of the costs including room and board charges, and starting on day 21 for up to 100 days, Medicare will pay 80% of the cost. The 2014 daily co-pay is $152 per day, and often is covered by suitable “gap” insurance. http://www.medicare.gov/coverage/skilled-nursing-facility-care.html

Circumstances arise where the patient starts rehab in one place (such as Florida, or near where they live) and for practical reasons needs to relocate (such as up to NJ to be closer to where their child/ren live who are helping coordinate the treatment). Other times, it becomes apparent that the patient will need to remain in a long-term care facility after the skilled care comes to an end, and the initial facility feels unsuitable for the long term. Whatever the reason, it is certainly possible to change facilities mid-stream.

The process requires you to speak with the receiving facility about the nature of the treatment plan and your interest in transferring there, and you must arrange with your current facility to send your medical records over. Sending facilities utilize certain summary forms that capture the essence of your health information for conditions/diagnoses, prescriptions, and daily treatment in process. Once the “receiving facility” informs you that they can accommodate your needs, the rest is just a question of working about the transportation, and the receiving facility will then perform its own assessment and devise its ongoing rehab or skilled nursing plan.

Understandably, the earlier you arrange for a transfer, the more likely you will find a cooperative receiving facility. Since skilled care and skilled rehabilitation involve a complex program of services, the receiving facility will want to be able to manage the services for as long as possible.

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5 thoughts on “Subacute Rehabilitation Care – You Can Change Facilities

  1. Pingback: Medicare and You: Skilled care can continue despite failure to improve. - Legal News You Can Use

  2. Thanks for posting this. I have been recieving post operative rehab that is not suitable. Now i know i can look elsewhere.

  3. My brother is in rehab in fort pierce fl. There are roaches everywhere also rat traps.. He’s getting little help. How can he get transferred to a better place

  4. I wanted him to go to a hospital that was more familiar in dealing with this type of problem.. He was sent from a country hospital that didn’t know what they were dealing with.

  5. It is so disheartening to be in desperate need of moving an ill, elderly loved one out of a facility that starves, medically neglects, coerces, and otherwise mentally and emotionally abuses them. FL DCF falsifys their reports when they do show up. The LTCO has no staff. ACHA takes literally months to respond. People that are supposedly hospital Patient Advocates and Social Services only serve as risk managers and real estate agents for facilities owned by cronies of elected officials….
    Old friends keep telling you “Call DCF” when you have begged that and every other applicable state and federal agency for help. Because such mental gymnastics and denial are required for them to just chalk up your loved one’s suffering as acceptable.
    Then while getting all your ducks in a row you run across whatever attorney websites and blogs, call every elder attorney in the region, get blown off by some lawyers that could save your loved one with five minutes of their expertise, and the message is clear. Your beloved will die a terrible, unnecessary death unless you can instantly write a $5000, maybe $15, 000 check.
    No local or state law enforcement agency will initiate an investigation even into their financial exploitation of tens of thousands of dollars. They refuse to take statements or submit reports about any criminal act or behavior on the part of hospital or facility administration and staff. They even say, “We can’t go in there” when the victim and witnesses are very anxious to make statements and offer evidence of criminal abide and neglect.
    The nightmare never ends, because even after what is likely a probable act of murder and definitely multiple acts of depraved indifference resulting in death, you can’t even retain an attorney to sue them and get the remaining spouse at least somewhat made whole in just dollars. You find out that the Florida Legislature has collectively, compliantly capped every possible insurance requirement for who are essentially rackateers and frequently national REIT’s running as many locations as possible, strictly in the service of their bottom line.
    Enough. Deaf ears and pearls before swine, right??

    Question: Which statute, administrative rule, etc, provides for the transfer away from a dangerous facility to another, provided of course that a bed is open there? Don’t tell me to call ANYONE that will not or cannot answer that specific question for me. My daddy is dead, but a dear friend’s mother is in big trouble where she is. No time for rabbit holes. Thank you for the use of this echo chamber, though. Maybe posting here will blip the right radar. ❤
    p.s. Anyone who can advise, or that I can help in any way is invited to hit me up on Messenger. Look for the profile pic of Lady Liberty covering her face in shame. 😒

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