Rehabilitation - Inpatient
With the increased risk for falls, and other injuries, among older adults there is a greater likelihood that there will be a need for inpatient rehabilitation. Because most older adults are insured through the Medicare program the options for inpatient rehabilitation for older adults are set up to comply with Medicare rules. Inpatient rehabilitation is paid for through the Medicare A program (hospital insurance).
Most inpatient rehabilitation for older adults occurs on one of three settings 1- Transitional Care Units (TCU) that are part of a general hospital, 2- Inpatient Rehabilitation Facilities (IRF), and 3- Skilled Nursing Facilities (SNF).
Transitional Care Unit (TCU)
Transitional Care Units (TCUs) combine the advantages of rehabilitation and long-term care with the services of an acute care hospital. TCUs provide services for patients who are convalescing as well as those who need long-term care. TCU patients are typically more medically complex and require more nursing care. The goal of these units is for each patient to achieve the highest level of independence through individualized treatment plans. TCU patients typically require less intense therapy than IRF patients. This is often due to the complexity of a patient’s medical condition. Although the majority of TCU patients require some form of therapy, there are patients on TCUs who receive none.
Inpatient Rehabilitation Facility (IRF)
Inpatient rehabilitation facilities serve patients with a multitude of diagnoses. The most common rehabilitation diagnoses include stroke, orthopedic conditions, arthritis, and spinal cord and traumatic brain injuries. Most patients are admitted directly from a hospital’s medical/surgical unit, but patients can be admitted from any level of care, as well as home.
Skilled Nursing Facility (SNF)
In order to be admitted to a SNF for rehabilitation treatment a person must be admitted from an acute care hospital, a TCU or a IRH. Medicare Part A provides payment for post-hospital care in skilled nursing facilities (SNFs) for up to 100 days during each spell of illness. A “spell of illness” begins on the first day a patient receives Medicare-covered inpatient hospital or skilled nursing facility care and ends when the patient has spent 60 consecutive days outside the institution, or remains in the institution but does not receive Medicare-coverable care for 60 consecutive days.
If Medicare coverage requirements are met, the patient is entitled to full coverage of the first 20 days of SNF care. From the 21st through the 100th day, Medicare pays for all covered services except for a daily co-insurance amount; which is adjusted annually. For 2007, the co-insurance for days 21-100 is $124.00/day.
Skilled nursing facility coverage includes the services generally available in a SNF: nursing care provided by registered professional nurses, bed and board, physical therapy, occupational therapy, speech therapy, social services, medications, supplies, equipment, and other services necessary to the health of the patient.
Please refer to the Resources section on this page for information about rehabilitation centers in Utah.