You’ve found yourself in need of therapy services, whether it be an emergency hospitalization, a recent decline at home, or an acute injury. How do you know what type of rehab setting is best? What will you be able to afford? Let’s review 3 common rehabilitation settings and what to expect from each.
SKILLED NURSING FACILITY (“SNF” or nursing home)
These 24-hour facilities provide short-term and/or long-term care. If you are hospitalized and are unable to care for your immediate medical or mobility needs, a skilled nursing facility may be recommended prior to transitioning home. The expected stay is approximately 7 days to 3 weeks but can continue for months depending on your progress and medical recovery.
Traditional Medicare allows up to 100 days of coverage, however, requires co-payment after 21 days. These copays average $200 per day. Commercial policies dictate how much therapy you will receive and can choose to discontinue coverage at any time, even if your therapy and nursing team document medical necessity.
While receiving services you may be treated in group sessions with other patients or individually. If the facility offers long-term care, you may share the gym with long-term residents receiving therapy as well. Sessions usually include one session per day from each discipline as required (OT, PT, Speech therapy). Each session lasts 30 to 60 minutes each, 5 to 7 days per week. The time of day you are seen, which therapist you see, and what days you have therapy is based on staffing availability and medicare requirements.
Common reasons for admission to a SNF include a sudden change in mental status, recovery after a major surgery, bone fractures, joint replacements, and cardiac, pulmonary or neurological conditions.
HOME HEALTH SERVICES
After returning home from a hospitalization or skilled nursing facility, home health services are typically covered by Medicare and Medicaid to facilitate a safe transition back home. A physical therapist, occupational therapist (and Speech therapist if needed) will make home visits to address your specific goals regarding strength, mobility, ADLs, and communication, swallowing, or cognitive improvement.
PT often addresses mobility and balance concerns within the home and provides a strength training program. OT can assess possible adaptations or equipment needs and make recommendations to improve independence and safety with ADLs. OT also focuses on functional mobility as it relates to your safety while completing daily tasks such as toileting, homemaking, and community access.
These visits are 2-3 times per week, per discipline. Visits last 3-6 weeks, or even longer if authorized by a doctor and approved by insurance. If you meet the required criteria, Medicare does not require a copay for home health services.
OUTPATIENT REHABILITATION
This service provides focus on a specific injury or deficit, such as joint, muscle, or neurological imbalance. These sessions last 45 to 60 minutes with use of modalities often used to treat pain and dysfunction. Examples of common modalities include ice, heat, electrical stimulation, and ultrasound. Traditional and commercial Medicare requires a 20% copay or a flat rate, depending on your policy. The amount of visits per week vary from 1 to 3 times and are approved based off of patient’s progress and performance.
WHAT IS BALANCE IN MOTION and HOW IS IT DIFFERENT?
Balance in Motion was founded to bridge the gap in which clients reach their mobility, self-care, cognitive health, and balance goals.
Rather than allowing insurance to dictate goals, duration, medical necessity, and financial reimbursement rates, the client directs their own training plan. After your free evaluation, specific goals are created together to achieve what is most important to you.
Client-centered exercises provide practice for everyday situations. These often include use of equipment, games, adaptive devices, or one on one training. Sessions typically last 45 to 60 minutes and frequency is based off client preferences. Rather than copays or medical authorizations, BIM has affordable payment options based the training style that will best fit your needs.
In addition to these services, BIM also provides options for home assessments and modification suggestions, group sessions, connections for transportation services, chair yoga sessions, and exploration of appropriate recreational activities. Join our community of independence-driven clients today with a free evaluation at Balance in Motion.
