Convalescent homes, commonly called Inpatient Rehabilitation Facilities (IRF), are facilities staffed by medical professionals who provide short-term care after a patient's surgery, injury or long-term illness.
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These facilities provide a multidisciplinary approach to treatment that includes physical, occupational and speech therapy, social services, recreation, and medication among others.
The goal of convalescent homes is to restore the patient's activities of daily living (ADLs)—feeding, toileting, grooming, bathing, dressing—so they can live independently again.
Convalescent Homes vs. Nursing Homes
A nursing home has the highest possible medical care outside of a hospital. It's for patients who are always at least going to need the same level of care.
To "convalesce" means to recover. The goal of a convalescent home is to get a patient well enough to return home. This may take 30 days or 3 months, but the goal is the same.
These facilities must meet a compliance threshold that says that no fewer than 60% of all patients must have at least 1 of 13 conditions:
- Spinal cord injury
- Hip fracture
- Brain injury
- Neurological disorder (e.g. Parkinson's, MS)
- Congenital deformity
- Major multiple trauma
- Three arthritis conditions
- Joint replacement for both knees or hips
Convalescent Homes Facts
- There are over 1,200 convalescent homes in the country in all 50 states and Washington D.C.
- According to the latest Medpac.gov study, about 20% of patients are admitted for stroke; 40% for fracture of the lower extremity; 11% for major joint replacement; and the remainder for a mix of other conditions.
- The average length of stay is 13 days.
- About 70% are discharged home; those not discharged usually end up in a nursing home. Of those discharged, about 50% need home health care.
What Are the Typical Services?
These vary from facility to facility, but in general, you'll find the following:
- Case management
- Skilled 24-hour nursing care
- Physical therapy
- Occupational therapy
- Speech-language therapy
- Cognitive therapy
- Recreational therapy
- Orthotic and prosthetic services
- Vocational rehab
- Social services
- Nutritional counseling
- Worship services
- Transportation services
Basic Care Requirements
Each patient's day in a convalescent home will be different, depending on his or her needs. However, there are some minimum requirements that must be met by the facility and the patient as regulated by the Centers for Medicare and Medicaid Services under the U.S. Department of Health and Human Services:
- Patient must receive at least 3 hours a day/5 days a week of physical and/or occupational therapy
- A patient's therapy must begin no later than 36 hours after they are admitted
- Patient's care is managed by a team that includes a physician, rehab nurse and a therapist
- The physician must meet face-to-face with the patient 3 days a week for assessing the patient "medically and functionally."
- The interdisciplinary team (doctor, nurse, therapist, etc.) must meet with the patient at least once every 7 days
- An expectation of measureable improvement in a reasonable time period must be shown
Paying for Convalescent Care
Medicare generally pays for the first 100 days of care broken down this way:
Days 1-20: Medicare pays for everything
Days 21-100: You pay a daily copayment (can be up to $128 or 20% of cost); Medicare pays the rest
Beyond 100 days: Medicare pays nothing
If you meet the income requirements, Medicaid may also help with payment. The Medicaid nursing home benefit is called Programs of All-Inclusive Care for the Elderly (PACE).
Medigap, for those in the Original Medicare Plan, may fill in some coverage holes.
Long-term care insurance is another option.
Convalescent homes or Inpatient Rehabilitation Facilities should not be confused with nursing homes. Nursing home care is a more permanent situation where the patients are expected to always receive the same if not a greater level of care.
The goal of a convalescent home is to rehabilitate the patient using an interdisciplinary approach (therapies, medications, recreation, etc.). And to enable them to perform activities of daily living so they can live independently.
Search for Convalescent homes using the nursing homes tab on this site.