Home Care or a Rehab Facility: Which Is Right?

The choice between home health care and a rehab facility depends on the patient's safe mobility and care intensity. A rehab facility is necessary if the patient requires 24/7 supervision and intensive physical therapy. Home health is appropriate if the patient safely return home and only needs intermittent therapy visits.

Both can work well. The social worker at the hospital can help you think through this.

Home health care consists of scheduled, intermittent visits (usually 2 to 3 times per week) by licensed nurses or physical, occupational, and speech therapists to a patient's home. Importantly, home health does not provide 24/7 supervision or custodial care like bathing and eating.

If your loved one needs around-the-clock help, home health alone may not be enough.

A rehab or skilled nursing facility is an inpatient center where a patient resides temporarily to receive round-the-clock nursing supervision and daily physical or occupational therapy. It is the safest option for patients who cannot walk independently or lack family members to assist them at home.

There is always someone available, day and night. Therapy happens on-site, often multiple times a day.

Medicare covers both options with distinct rules. Medicare pays for home health if a physician certifies the patient is structurally "homebound" and requires intermittent skilled care. Medicare pays for a rehab facility only if the patient had a qualifying 3-day inpatient hospital stay and needs daily intensive therapy.

Always call the insurance company to confirm what is covered before making a decision.

Home health care is only safe if the patient can safely navigate to the bathroom independently, or if a capable family member or private caregiver is physically present in the home 24/7 to prevent falls. If neither is true, they require a rehab facility.

Ask yourself: "Is my loved one safe being home without someone there at all times?"