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Caring Senior Service of San Antonio

Caring Senior Service of San Antonio Blog

Providing senior in-home care tips and stories for everything related to senior care.

When Does Medicare Pay for Inpatient Rehabilitation Hospital Stays for Seniors?

Posted by Ruby Cemental on Sep 12, 2017 5:30:00 PM

Rehab_seniors-LR.jpgMedicare Part A (Hospital) coverage for seniors will pay for a qualified stay in an inpatient rehabilitation hospital with the same out-of-pocket costs as a traditional hospital stay. However, there are certain qualifying factors that must be met to ensure that the stay will be covered. Some common conditions that meet approval for Medicare coverage of an inpatient rehabilitation hospital stay include a spinal cord injury, head injury, or stroke. Recovery from a joint replacement without an additional complicating condition may not warrant admission to an inpatient rehabilitation hospital, but you could still qualify for rehabilitation care through a skilled nursing facility admission, home health care, or in an outpatient setting.

In order to qualify for an inpatient rehabilitation hospital admission, your physician must deem the care medically necessary. In order for this to be a qualifying admission, you must require the following:

Accessibility of a physician 24 hours a day, seven days a week. You must require the direct involvement of a physician every two to three days during your stay.
  • Accessibility of a registered nurse with rehabilitation care experience.
  • Rigorous daily therapy, typically consisting of three hours of therapy. If you are too ill to endure three hours of therapy daily, you may still qualify. 
  • A qualified team consisting minimally of one physician, one registered nurse, and one therapist. 
  • Your condition must be expected to continue to improve to a level that you will be able to function more independently and not require the assistance of a residential facility. This could include your ability to live on your own or with the assistance of family. 

Medicare Part A coverage can cover admission for seniors to an inpatient rehabilitation hospital, but there are a number of qualifying criteria that must be met. 

At Caring Senior Service, our expert staff is comprised of extremely knowledgeable, friendly, and trusted professionals who take pride in helping your loved one manage their daily activities. Contact us today to learn more!

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