Skilled nursing, inpatient rehab or a long-term care hospital?

When someone is ready to leave the hospital but not ready to go home, the discharge planner will usually suggest one of three places. They sound alike, but the amount of care is very different.

	Skilled nursing facility	Inpatient rehab facility	Long-term care hospital
Who it's for	People who need daily nursing or therapy at a moderate pace	People who can handle intensive therapy, often after a stroke, brain or spinal cord injury, amputation or major joint surgery	People with serious medical needs that will take a long hospital stay, such as weaning off a ventilator or complex wounds
How much therapy	Varies. Often an hour or two a day	Generally at least 3 hours a day, 5 days a week	Whatever the medical condition allows
Doctors	Visit periodically	Close physician oversight	Hospital-level care every day
Typical length	Days to several weeks	Often around one to two weeks	Often 25 days or more

Medicare has different coverage rules for each. Skilled nursing coverage usually requires a qualifying inpatient hospital stay first.

Two questions are worth asking the discharge planner. First, why this level of care and not the one above or below it? Second, which facilities can you choose from? You do get a say, as long as the place can meet the patient's needs and has room.