Hospital Discharge

After a loved one has spent days in the hospital, the last thing you wish to be faced with is another unknown. You’re fully immersed in hospital jargon. You’re beginning to grasp the meaning of blood gas, CBCs, and chem panels. And now, the hospital discharge coordinator excitedly announces their release. With that comes a mouthful of new terms and a long list of local “care” facilities to choose from. Ideally, the route is straight home. But home isn’t outfitted with ramps, wheelchairs, grab bars, and sit-to-stand aids. The discharge options — nursing home, rehab, skilled care — present a whole new set of questions. To you, these facilities look like names on a list, so how do you choose? What’s the difference between nursing home, rehab, and skilled care? Once we clear up a matter of semantics, the decision on which facility to choose becomes easier.

Nursing Home! Say What?

The title, “nursing home,” sounds so antiquated. Sending a loved one to a nursing home doesn’t mean putting them out to pasture. Nursing homes (aka skilled care facilities) are staffed by round-the-clock medical professionals. The care received in a nursing home is much like what one receives at the hospital. Nurses and nursing assistants are available to meet an individual’s needs at all hours of the day. They work closely with the managing physician, monitoring vital signs, and assessing imminent medical changes. They can dispense medication and help with hygiene. Nursing homes are outfitted with mobility aids such as wheelchairs, hoyer lifts, and shower seats. Often these facilities are closely affiliated with hospitals, sharing ambulatory transportation should the need arise. Post discharge, nursing homes are a comfortable place to recover while under the constant supervision of medical professionals.

Nurses Put the Skill In Skilled Care

“Skilled care facility” is really just a new(er) name for “nursing home” — it’s a rebranding to reduce some of the negative connotations once associated with nursing homes. Skilled care facilities are staffed by the dedicated, skilled providers that the name implies. These professionals include nurses, nurse practitioners, physical/occupational/speech therapists, and in some cases, physicians. No matter how it’s said, skilled care and nursing homes are labels for the same type of inpatient facility. Providing total care — both skilled and personal — under one roof.

Rehab is a Service Provided at Nursing Homes and Skilled Care Facilities

The “rehab” that the hospital social worker speaks about at discharge is a service, not a place. Rehab, as it’s being referenced in this situation, is provided at nursing/skilled care facilities. It’s the prescribed therapy that helps individuals regain skills they had prior to hospitalization. Skills might include talking, swallowing, standing from a seated position, and walking.

Nursing Home, Rehab, Skilled Care, or Home — How Do You Choose?

Now that the semantics are cleared up, it’s time to make a decision. Are you and your loved one prepared to return home without a detour to an inpatient skilled care facility? Can you make the necessary accommodations at home with mobility aids and hired care personnel? If this isn’t an immediate option, it may be after a brief stay at a skilled care facility. Whatever the case, it’s back to the discharge coordinator’s list. A list so banal that making a choice seems a lot like throwing darts. So, how do you choose? The releasing hospital is unable to provide recommendations so it’s up to you to do a little research. Sources for recommendations include:

  • Personal referrals
  • Social Media
  • Online reviews
  • Site visits

The type and frequency of care that is provided at a facility is a little different than how it works at home. Typically, care within a facility is more intensive:

Inpatient Care Facility At Home
Privacy No Yes
Available Beds Changes Daily Yes
On-site Therapy Yes Yes, if prescribed*
Frequency of Therapy Daily Weekly
Professional Nursing Care 24/7 Maybe*
Hired Personal Care Yes Maybe*
Medicare Coverage Yes, if the facility accepts Maybe**

* Can be arranged through a home health agency or hired independently   ** Must meet Medicare qualifications

As confusing as it sounds at first mention, hospital discharge options — Nursing Home, Rehab, Skilled Care, or Home — are actually pretty simple. Nursing homes and skilled care are one and the same: inpatient recovery facilities. Rehab describes the therapy that takes places within these facilities. Obviously, home is the ultimate goal, whether straight from the hospital or via rehab.

Ultimately, the choice is yours. If you need additional care at home, Home Care Assist is here to help. Our network of vetted and qualified in-home caregivers provides a cost-effective alternative to hiring an agency. Activate a FREE 15-day pass to view available caregivers in your area, who match your needs.