Rehab after a hospital stay: nursing home rehab, inpatient rehab, or home health, and what Medicare pays

The three doors

• Short-term rehab in a skilled nursing facility (SNF): a nursing home bed with therapy most days, for someone who needs daily skilled care and can take part in therapy but not for hours at a time. Common after a hip fracture, a stroke, or a long illness.
• Inpatient rehabilitation facility (IRF): a rehab hospital or unit with intensive therapy, usually several hours a day, and a doctor seeing the patient often. For people who can tolerate it and need that much. Less common; the hospital's rehab doctor decides who qualifies.
• Home health: a nurse and therapists who come to the house a few times a week, for someone who can get by at home between visits with family help, and who has trouble leaving home.

What Original Medicare pays, in general

These are the general rules for Original Medicare. Medicare Advantage plans cover the same services but often with prior approval and their own networks and copays; ask the plan.

• SNF rehab: needs a qualifying inpatient hospital stay of three or more days and a move into the SNF generally within 30 days. Medicare covers up to 100 days per benefit period: days 1 through 20 at no daily charge, days 21 through 100 with a daily coinsurance ($217 a day in 2026), and nothing after day 100. Most people are discharged well before day 100, when therapy goals are met or progress stops.
• Inpatient rehab: covered under Part A like a hospital stay, with the hospital deductible and daily charges after 60 days. No three-day rule, but a doctor must certify the need for intensive rehab.
• Home health: no hospital stay required. Covered at no charge for the visits when a doctor orders it, the person needs part-time skilled care, and they are homebound. Equipment like a walker is 20 percent after the Part B deductible.
• None of these cover long-term custodial care, meaning help with bathing and meals when that is the only need.

Choosing between them

• Ask the hospital therapist, not just the planner: how many hours a day can she tolerate, and how much help does she need to get to the bathroom?
• If home is possible with family help around the clock for the first week, home health lets people recover in their own bed. Be honest about whether that help exists.
• If nights are the problem, or nobody can be there, SNF rehab buys time to arrange the house and the help.
• Ask which SNFs have accepted the referral, then look each one up on Care Compare and NYS Health Profiles before you say yes. You can choose.
• If the person had been living alone and struggling before the hospital, say so. Rehab is often where families learn what the real level of need is.

Getting the most from a rehab stay

• Go to the care plan meeting in the first week and ask for the therapy goals in writing, with a target date.
• Ask how many minutes of therapy per day are actually happening. Weekends are often lighter.
• Visit at a mealtime, and make sure the medicine list from the hospital matches what the SNF is giving.
• Ask early what the plan is for discharge: home with home health, assisted living, or staying long term. Do not let the end of coverage be the plan.
• When the SNF says Medicare coverage is ending, you get a written notice and can ask for a fast appeal if you think it is too soon. The number is on the notice.

If rehab becomes long-term care

Sometimes progress stops and the person cannot go home. That is a different conversation about long-term care and how it is paid for, usually privately or by Medicaid. Ask the SNF social worker early whether the home takes long-term residents and Medicaid, so you are not moving twice. Our paying-for-care article covers the money, and a Cardinal advisor can help you look at the choices.