The Role of Skilled Nursing Facilities in Rehabilitation

After a hospital stay, seniors who require more than just home health care are often discharged to skilled nursing facilities (SNF). Also known as subacute rehabilitation hospitals, these short-term transitional care providers are typically Medicare-covered.

They offer around-the-clock skilled nursing services like wound care, injections, and rehabilitative therapies. Generally, patients receive physical, occupational and speech therapy to help them return home.

Physical Therapy

When an older adult needs more than just hospital care for a serious health issue or medical crisis, skilled nursing facilities provide the additional healthcare they need to recover fully. These facilities are licensed by the Centers for Medicare & Medicaid Services and are subject to periodic inspections to ensure high standards.

Skilled nursing facilities (SNFs or nursing homes) are inpatient care settings that offer round-the-clock treatment by registered nurses and licensed healthcare professionals such as physical, occupational and speech therapists. Most Medicare beneficiaries who require short-term inpatient care following a qualifying hospital stay will receive 100 days of skilled nursing care benefits under Part A of the Medicare program.

The primary difference between SNFs and hospitals is that SNFs focus on providing medical treatment in a safe, secure environment. In contrast, hospitals are more structured to accommodate acute care for people with severe and complex health conditions. This focus on medical treatment helps prevent complications, reduce hospital readmission risk, and decrease associated healthcare costs.

Occupational Therapy

After a stroke or serious injury, managing daily tasks such as dressing and eating can be difficult. Occupational therapy at skilled nursing facilities is designed to help seniors regain their independence by teaching them how to cope with their injuries and illnesses.

Speech therapy is another important aspect of rehabilitation. It can include exercises to improve speech clarity and teach patients how to speak in different situations. It can also focus on swallowing and emphasize dietary guidelines.

A doctor prescribes skilled nursing care if your loved one’s condition has declined significantly after a hospital stay and they aren’t ready to return home. They may require frequent or around-the-clock care and professional medical treatment like intravenous (IV) therapy, injections or wound care. Medicare typically covers this type of care.

Speech Therapy

The speech and language pathology team addresses communication problems, swallowing dysfunction and aphasia (partially or completely lost ability to understand spoken words). They create a treatment plan that assists with language comprehension, provides alternate communication strategies and makes diet recommendations.

Skilled nursing facilities provide round-the-clock care for people with serious medical needs that can’t be cared for in a hospital. These conditions include severe injury, post-surgery or illness that requires close monitoring and extensive medical services such as tube feedings and intravenous injections.

Medicare covers stays in a skilled nursing facility when a doctor prescribes specialized physical and occupational therapy, medications, medical equipment and supplies, social services and dietary counseling. Patients can also receive home health care with a registered nurse and physical or occupational therapists who visit them in their homes. Home health aides can also perform wound care, check vital signs and administer medication. However, these services don’t have the same level of frequency and intensity that skilled nursing communities can offer.

Physiatry

When it’s time for your loved one to leave the hospital, they may need continued attentive care unavailable in their home. Skilled nursing facilities provide a transitional environment with various treatment options for short or long-term rehabilitation.

Patients who go to skilled nursing facilities require daily specialty treatments that health professionals evaluate weekly for progress. Licensed nurses and physical, occupational, speech and music therapists help these patients recover the skills necessary to navigate daily tasks like dressing, eating, bathing, moving, etc.

Physiatry plays an important role in these settings by monitoring and managing complex medical conditions such as delirium, oxygenation, and chronic pain. During the COVID-19 pandemic, physiatrists helped support their colleagues across disciplines by building professional relationships and ensuring that patient needs were met as they shifted from hospitals to IRFs. This demonstrated the value that PM&R brings to the healthcare system.