When your loved one requires rehabilitation after a hospitalization, injury, or surgery, the choice of next steps for their care can be very confusing. The terms “In-Patient Rehabilitation Hospitals” known as IPR’s and “Skilled Nursing Facility,” better known as SNFs, are often used synonymously. Still, they provide very different levels of care and treat very different patient needs.
The selection of a care facility for oneself or a loved one is considered one of the major decisions that one may make, which in turn may greatly affect wellness and recovery. Whether it is post-surgery rehabilitation, management of a chronic illness, or healing from injury, understanding the difference between a Skilled Nursing Facility and an In- Patient Rehabilitation Center is quite vital in making an appropriate choice.
Why the Right Care Facility Matters:
It is very important to identify the level of care needed to ensure you or your loved one receives the appropriate care and support. A care facility suited to your needs can make all the difference in the process of recovery by providing access to specialist care, individualized treatment, and access to many other important resources. Identifying an individual’s needs, personal preferences, and long-term goals assists with determining which facility is appropriate for their care.
Skilled Nursing Facilities vs. In-Patient Rehab Centers: What’s the Difference?
In-Patient rehabilitation facilities are designed to treat patients who require intensive therapy following incapacitating diseases, surgery, or injuries. The centers provide at least three hours a day of therapy, five days a week, with a physician playing an active role in the daily care, overseeing treatment.
Skilled nursing facilities are, however, distinctly less intensive, thus providing only subacute rehabilitation and offering one hour of therapy each day, with physicians intervening only on selected occasions, though often monitoring the patient’s progress over time.
Other key differences include:
- Physician Involvement: In an inpatient rehabilitation facility, the specialty-led team will meet weekly to discuss updates on patients enrolled in rehab. In SNFs, it is rare for doctors to be actively involved in daily caregiving.
- Medicare Coverage: Under premises set forth by Medicare, the usual coverage is up to 14 days in an in-patient rehab facility and up to 21 days in a skilled nursing facility at 100% coverage.
- Hospital Stay Requirement: For a patient to receive Medicare coverage under SNF, the individual must have stayed three days in a hospital setting. This stipulation does not carry over to in-patient rehabilitation.
Both Skilled Nursing Facilities and Inpatient Rehab Centers provide important and special care, but they are used for different purposes. Let us take a closer look at each one:
Skilled Nursing Facilities (SNFs)
Skilled nursing facilities provide round-the-clock medical care for people with chronic conditions, disabilities, or those recovering from surgery or hospitalizations. These are not the same as nursing homes, as a nursing home is a permanent residence for 24/7 care, while a skilled nursing facility is a temporary residence for patients undergoing medical rehabilitation treatment. While many facilities are listed as skilled nursing facilities, many have a single or multiple wings of rehabilitation and more wings with nursing home care being provided, they often designate the long-term wings as their assisted living side.
These facilities offer a comprehensive range of services, including medical monitoring, physical therapy, and assistance with daily activities like bathing, dressing, and eating. While SNFs also provide rehabilitation services, they tend to focus more on recovery for patients needing less intensive care than provided in an Inpatient Rehab Center.
Services and Care Provided at Skilled Nursing Facilities:
Skilled nursing facilities are designed to provide comprehensive medical care and assistance for those who need close medical supervision or assistance in daily activities. These common services include:
- 24/7 Nursing Care: Caring licensed nurses are available 24 hours a day to manage health, dispensing complex medications, and deliver other treatments.
- Rehabilitative Services: Physical, occupational, and speech therapies are offered for about one hour per day. This helps patients regain their previous strength, mobility, and cognitive abilities.
- Daily Living Assistance: The staff, not the nurses, helps the residents with activities of daily living, also known as ADLs, including eating, dressing, bathing, and grooming.
- Medication Management: SNFs are supposed to handle medication properly and monitor for interactions or complications.
- Medical Monitoring: The staff may closely monitor vital signs, wound care, and chronic disease management to ensure continued health and stability are maintained.
- Longer Stays: SNFs are often used for longer-term stays, especially if a patient cannot go home immediately but no longer requires the high level of care provided by a hospital or an IPR.
Inpatient Rehabilitation Centers (IPRs)
An inpatient rehabilitation hospital is a specialized medical facility where patients stay overnight for therapy and medical care after a serious injury, illness, or surgery. It focuses on regaining lost abilities through physical, occupational, and speech therapy, aiming to restore patients’ independence and restore their previous level of function. Average stays are typically 10 to 14 days.
Inpatient rehabilitation Hospitals are for patients needing intensive rehabilitation therapy along with a higher level of medical care. The hospitals are specially equipped with equipment and staff, including doctors, nurses, physical therapists, occupational therapists, and speech therapists.
Services and Care Provided at Inpatient Rehab Centers:
In-Patient rehabilitation facilities are designed for intensive recovery services for patients with specific rehabilitation needs. These facilities focus on the restoration of functional independence and the improvement of the quality of life of patients after surgery, injury, or illness. Key services include:
- 24/7 Medical Care: Medical professionals are always available to manage health concerns and ensure safe recovery.
- Physical Therapy: Therapists help patients regain strength, mobility, and coordination through personalized treatment plans for three hours or longer, usually one hour per therapy type (one hour of Physical Therapy, Occupational Therapy, and Speech Therapy.) There may also be group therapy sessions in conjunction with the standard disciplines.
- Occupational Therapy: These therapists engage the patients in relearning vital activities of daily living, such as dressing, bathing, and cooking, using adaptive equipment whenever necessary.
- Speech Therapy: Speech therapists assist patients in regaining the art of communication or address difficulties in swallowing food.
- Psychological Support: Most rehabilitation centers have counseling or support groups to assist patients with the psychological challenges or health events associated with recovery.
Factors to Consider When Choosing a Care Facility:
- Medical Needs
Cognitive and Physical abilities also may impact options offered, if the senior cannot retain the education for therapy, they may not be appropriate for an IPR and better served in a SNF setting. The same is true for those with major physical limitations; it may be best to rehabilitate at an SNF in a slower setting.
Skilled Nursing Facilities are ideal for patients who require continuous medical supervision or assistance with chronic conditions, such as diabetes, respiratory problems, or post-surgical recovery.
Inpatient rehabilitation settings would be more appropriate for those rehabilitating and recovering from certain conditions, such as stroke, joint replacement surgery, or traumatic injury.
- Length of Care
IPR is a more intense and faster therapy, usually getting recovery started much faster and getting you back on the road to recovery at home or senior living quicker. In contrast, Skilled Nursing is a slower process and, subsequently, slower recovery.
Skilled nursing facilities are designed for long-term care, thus being appropriate for those patients who need extended help with activities of daily living and health monitoring.
Inpatient rehab centers provide short-term care-usually in the span of a few weeks-for intensive rehabilitation and therapy.
- Insurance Coverage
It is essential to know your insurance coverage. Many plans may cover either an SNF or an IPR under different terms and conditions. You should contact your insurance provider to discuss coverage when searching for the best option for you or a loved one. Your Medicare coverage plays a huge role in the options you are provided by the hospitals at discharge, if you have Advantage plans, your carrier must have contracts in place for IPR or any SNF offered to you, which can greatly limit your options.
SNFs: Average stays at 100% coverage are up to 21 days, under Medicare guidelines, you can stay for up to 100 days with out-of-pocket co-payments and private pay.
Need Help Navigating Your Options?
If you are looking for a skilled nursing facility or inpatient rehab center in the Central Texas and the Texas Hill Country area, let our team here at Oasis Senior Advisors: Austin and Central Texas help. We understand the difficulty and frustration that often accompanies this type of decision and offer free, no-obligation consultations to point you in the right direction to the best care options available.
Call us now to explore options and select the ideal care facility for yourself or your loved one!
Written for Oasis Senior Advisors by Lauren Hope Bartling
References:
Murphy, B. (2021, October 15). The difference between nursing homes and skilled nursing facilities. Nursing Home vs Skilled Nursing: What’s the Difference & What Do You Need? | Hebrew SeniorLife. https://www.hebrewseniorlife.org/blog/difference-between-nursing-homes-and-skilled-nursing-facilities
Skilled nursing facility vs inpatient rehab. Home – Willows Healthcare. (2024, July 1). https://www.willowshealthcare.com/blog/skilled-nursing-facility-vs-inpatient-rehab
