Choosing the Right Care for You

By Dr. Elissa Charbonneau

After a hospital stay, your physician or case manager may recommend you transition to another setting of care as part of your recovery. However, not all settings are the same.

If you are recovering from a stroke or other serious injury or illness, inpatient rehabilitation - where you receive intensive therapy and a hospital level of care - could be right for you. While your care team could refer you to a different setting, as a patient, you have a choice in where you go. In fact, it is your right.

Know Your Options Before You Need Them

Post-acute care is rehabilitation or palliative care that a patient receives after a stay in an acute care hospital, or in some instances, in lieu of a hospital stay. That care can take place in the home or in a facility, depending on the patient’s needs. The most common forms of post-acute care are home health, inpatient rehabilitation, skilling nursing and long-term care.

Inpatient rehabilitation provides a hospital level of care with intensive therapy to help you regain your independence and ultimately return to your community. While at an inpatient rehabilitation hospital, you will receive three hours of therapy a day, five days week. You will also have frequent visits from a rehabilitation physician and other physicians, depending on your needs. Nursing care is provided around the clock, and a multi-disciplinary team that includes rehabilitation physicians, nurses, therapists, dietitians, pharmacists and case managers will design a unique care plan to fit your goals.

Conditions commonly treated at rehabilitation hospitals include stroke, head or spinal cord injuries, neurological disorders such as Parkinson’s and multiple sclerosis, and amputation and hip fractures.

Will Insurance Cover Inpatient Rehabilitation?

That depends on your insurance and your coverage. You do have to meet certain medical requirements for the different settings of care to receive Medicare coverage. Also, some Medicare plans, such as Medicare Advantage ones, limit you to providers within their network. Work with your care team or primary care physician to determine if you meet the requirements for inpatient rehabilitation. Make sure to discuss your goals, so they can fully understand your long-term needs. In some circumstances, you can consult with your preferred provider to see if they can work with your insurance to help you receive coverage.

Do Your Research

Your care team is required to provide you and your loved one with information concerning the quality of care of providers in your area, but take time to do a little research yourself. Look at patient reviews on websites. Ask family and friends with similar conditions who have had good outcomes and experiences. Where and who you receive care from matters, so take time to look around and find the best provider to help you reach your recovery goals.

Dr. Elissa Charbonneau is Chief Medical Officer, Encompass Health. For more information, visit encompasshealth.com/pittsburghrehab.