After a hospital stay, deciding what to do next can be overwhelming, especially when you’re unsure which option best suits your loved one’s needs. As a caregiver, you want to ensure that your family member receives the best care possible. The choice between a skilled nursing facility and a rehabilitation center is consequential, and understanding which one will best support your loved one’s recovery, comfort and independence is key.
To help guide this decision, focus on your loved one’s specific needs and recovery goals, advises Christopher Norman, a board-certified geriatric nurse practitioner with the National Council on Aging. He explains that if ongoing medical care is required with limited potential for rehabilitation, a skilled nursing facility may be the best choice. However, if partial or full recovery is possible, a rehabilitation center may be a better fit.
By understanding the key differences between these two options and the specialized services available in each, you’ll be empowered to make an informed decision — one that reflects your loved one’s individual recovery journey and personal goals.
Skilled nursing facility vs. rehab center: How they differ
Both rehabilitation centers and skilled nursing facilities provide valuable services, but they cater to different needs.
Goals of facility
Jessica Corona-Irwin, certified dementia practitioner, at Remo Health in Columbiana, Ohio, says rehab facilities are designed to help people who need to recover from injuries, surgeries or illnesses. “The primary goal for these facilities is to improve physical, cognitive and functional abilities to enable patients to return to their daily lives as independently as possible,” she says.
Norman says skilled nursing facilities, however, are designed for long-term care, providing continuous medical or nursing support for individuals who need it. “They offer around-the-clock care and primarily focus on maintaining residents’ health rather than making drastic improvements,” he adds.
Level of care
“Short-term care facilities, such as rehab centers, focus on intensive staffing, daily doctor visits, a higher nurse-to-patient ratio and multiple therapy sessions per day, with a short-term focus on rehabilitation,” says Corona-Irwin. She notes long-term care facilities, like skilled nursing facilities, typically have less frequent doctor visits and a lower nurse-to-patient ratio.
She notes that skilled nursing facilities still provide 24/7 nursing care and regular therapy sessions, but they are better equipped to manage the long-term needs of patients and have trained staff to provide comprehensive care. She notes this is especially important for patients with dementia who require specialized programs.
Duration of stay
Norman says, “Rehab centers are intended for shorter stays and focus on recovery following surgeries or severe health episodes, like strokes or heart attacks.”
“The length of stay in a skilled nursing facility can be longer, ranging from a few weeks to several years, depending on the individual’s needs and health condition,” says Corona-Irwin.
Patient population
In skilled nursing facilities, the patient population may include elderly patients or those with chronic conditions like dementia or pulmonary conditions who require long-term care. In contrast, rehab centers typically treat patients recovering from major surgeries, strokes or injuries, which requires more rehabilitation-focused expertise.
Skilled nursing facility staff vs. rehab center staff
Both facilities have access to many of the same types of therapies and specialists, says Corona-Irwin, but rehab facilities often have a wider range of specialists on staff or on call, especially for short-term rehabilitation goals.
Rehab-centered certifications
In a rehab center, there is often a greater emphasis on certifications related to rehabilitation nursing, specialized therapy certifications and post-acute recovery (e.g.,certified rehabilitation registered nurse, neurologic clinical specialist or an orthopedic clinical specialist).
Patient-to-physician ratios
Rehab centers have a higher patient-to-therapist ratio due to the intensity of therapy needs. Skilled nursing facilities are primarily staffed with certified nursing assistants and registered nurses who will manage medication and medical oversight.
Long-term care vs. short-term care
In long-term care facilities, specialists play more of a consulting role for managing chronic or end-stage conditions, whereas in rehab centers, specialists are engaged in helping patients achieve short-term recovery.
How to choose the right place for your loved one
When deciding between a skilled nursing facility and a rehab center, it’s essential to match the rehabilitation goals and care needs with the therapy intensity offered at each facility.
Assess the level of recovery needed
If your loved one is recovering from a recent medical event and has a strong chance of regaining function, a rehab center may be the better option, says Norman. He notes these centers provide intensive therapy, which can help the patient regain strength, mobility and independence.
On the other hand, he says if your loved one’s medical needs are more complex, or if they are unlikely to regain full functionality, a skilled nursing facility may be a better fit, especially if they need ongoing medical support and help with daily activities.
Manage expectations
It’s important to have an honest conversation with your loved one’s healthcare providers about the likely outcomes of rehabilitation, says Norman. He explains: “If there is a realistic potential for progress, such as recovering from a fall or stroke, a rehab center can help. However, if your loved one has chronic health conditions or advanced dementia, a skilled nursing facility may be more appropriate for their needs.”
Involve your loved one in the decision
Experts agree that you should involve your loved one in the decision-making process as much as possible. Ask them about their preferences regarding therapy frequency, room arrangements and the atmosphere of the facility. For instance, do they prefer a location with a quiet, home-like environment or one with more social activities? Knowing their preferences can help narrow down the options and ensure they feel comfortable in their temporary home.
Keep proximity to family in mind
The location of the facility plays a crucial role in maintaining your loved one’s emotional well-being. Norman recommends looking for facilities that are reasonably close to home or family members, while still meeting the care needs. Being close to family members allows for more frequent visits, which can improve morale and speed recovery.
Review insurance coverage
Norman explains many seniors on Medicare Part A will have coverage for rehab stays following a qualifying hospital stay (usually a 3-day inpatient stay). Medicare typically covers a short-term rehab stay for up to 100 days, depending on the patient’s progress. However, there may be out-of-pocket costs for certain services, so Norman notes that it’s important to review your insurance policy or consult with the facility’s billing department to ensure the services you need are covered.
Consider the environment
Take into account the atmosphere when choosing between options. A rehab center or skilled nursing facility with a clean, well-maintained environment and a friendly, professional staff can make a significant difference in recovery. As Corona-Irwin points out, rehabs will have a more intensive environment similar to a hospital, whereas skilled nursing facilities often provide a more residential setting. “The environment is designed to be comfortable and homelike, with a balance between medical care and daily living activities,” says Corona-Irwin.
A final word on skilled nursing facilities vs. rehab
After a hospital stay, choosing where to go next doesn’t have to be stressful. Assessing the needs and goals is the first step to making an informed decision. This process may include a comprehensive assessment by a multidisciplinary team — including doctors, nurses, social workers and therapists — which is crucial to determine the most appropriate care plan and whether a short-term rehab stay or a skilled nursing facility works best for your specific needs. Corona-Irwin says patients should always consult with a doctor and medical team when evaluating these decisions.
Understanding the certifications and specialized care available in each facility can help ensure your loved one receives the appropriate level of care for their ultimate recovery or ongoing health needs.
“It’s essential to approach the decision with an open mind and realistic expectations,” Norman advises. He says, “While it’s understandable to want the best care possible, recognizing the limits of resources and being prepared to advocate for your loved one’s needs can help make the experience more manageable for everyone.”
