New Orleans Senior AdvisorWhat is the difference between short-term rehab and long-term nursing care?
Short-term rehab is a skilled nursing facility stay after a hospital admission, focused on therapy and recovery and usually paid by Medicare, while long-term nursing care is ongoing residence in a nursing home for someone who cannot safely live elsewhere, paid privately or by Louisiana Medicaid.
Many New Orleans nursing homes do both, often on separate units. A parent discharged from Ochsner or Touro to a rehab unit may later move to the long-term side of the same building if recovery stalls. The admission paperwork, the payer and often the room change at that point.
How long does Medicare pay for rehab in a nursing home?
Medicare can pay for up to 100 days of skilled nursing facility care per benefit period after a qualifying inpatient hospital stay, but only while the patient needs and is making use of daily skilled care; coverage often ends well before day 100.
When the facility decides skilled care is no longer needed, it must give written notice and explain how to appeal. Families can request a fast appeal. Ask on admission how progress is measured and when the team expects to discuss discharge.
What happens when Medicare rehab ends and a parent cannot go home?
The family chooses among paying privately to stay, applying for Louisiana Medicaid if the parent qualifies, moving to an ARCP if needs fit its level, or going home with Community Choices Waiver, LT-PCS, PACE or private help.
The time to plan is the first week of rehab, not the last day. Ask the social worker whether a long-term bed is available, whether the home is Medicaid-certified, and whether your parent's level of care has already been determined by OAAS, which happens for every admission to a Medicaid-certified home.
How do I choose a rehab facility after a New Orleans hospital stay?
Ask the hospital for the list of skilled nursing facilities with an available bed, then check each one's CMS health inspection, staffing and quality ratings, distance from family, and whether it has a long-term unit if recovery is incomplete.
Our nursing home pages show CMS ratings, nurse staffing hours and the latest inspection for every certified home in the six parishes. Short-stay quality measures, such as rehospitalization and discharge to the community, are especially relevant for rehab; ask the facility for them.
Can rehab happen somewhere other than a nursing home?
Yes: some patients go to an inpatient rehabilitation hospital for more intensive therapy, others to a long-term acute care hospital for complex medical needs, and others home with Medicare home health.
LDH's roster for the region includes inpatient rehabilitation hospitals such as Ochsner Rehabilitation Hospital and North Shore Rehabilitation Hospital, and long-term acute care hospitals; the physician and hospital case manager decide which level fits.
At a glance
| Short-term rehab | Long-term nursing care | |
|---|---|---|
| Goal | Recovery and return home | Ongoing care and safety |
| Payer | Medicare after a qualifying stay | Private pay or Louisiana Medicaid |
| Length | Days to weeks | Months to years |
| Planning | Discharge planning from day one | Medicaid application and personal allowance |
Sources include LAC 48:I.Chapter 68 (adult residential care providers), the Louisiana Department of Health's Health Standards Section and Office of Aging and Adult Services pages, the Governor's Office of Elderly Affairs, CareScout and VA rate tables as cited above; see our editorial standards.
