When you no longer need the amount of care provided in the hospital, the hospital will begin the process to discharge you.

Most people hope to go straight home from the hospital after surgery or being ill. But even if you and your health care provider planned for you to go home, your recovery may be slower than expected. So, you may need to go to a skilled nursing or rehabilitation facility.

Skilled nursing facilities provide care for people who are not yet able to care for themselves at home. After your stay at the facility, you may be able to return home and care for yourself.

SNF; SAR; Sub-acute rehab

If your surgery is planned ahead of time (elective), discuss discharge arrangements with your providers in the weeks beforehand. They can tell you whether going straight home will be good for you.

If your stay in the hospital was not planned, you or your family should discuss discharge arrangements with your provider as soon as possible during your time in the hospital. Most hospitals have staff who coordinate discharge planning.

Planning ahead helps ensure you can go to a place that provides high-quality care and is located where you would like it to be. Keep in mind:

• You should have more than one choice. If there is no bed available in the skilled nursing facility that is your first choice, the hospital will need to discharge you to another qualified facility.
• Make sure the hospital staff knows about the places you have chosen.
• Have someone check if your health insurance will cover your stay at the facility.

It is always a good idea to check out different skilled nursing facilities. Visit two or three places and choose more than one facility where you would be comfortable.

Things to consider when choosing a place:

• Where the facility is located
• How well it is decorated and maintained
• What the meals are like
• Whether the staff is a good match for your needs

Get answers to questions like:

• Do they take care of many people with your medical problem? For example, if you had a hip replacement or stroke, how many people with your problem have they cared for? A good facility should be able to provide you with data that shows they give good quality care.
• Do they have a pathway, or protocol, for taking care of people with your medical condition?
• Do they have physical therapists who work at the facility?
• Will you see the same one or two therapists most days?
• Do they provide therapy every day, including Saturday and Sunday?
• How long do the therapy sessions last?
• If your provider or surgeon does not visit the facility, will there be a provider in charge of your care?
• Will staff take the time to train you and your family or caregivers about care you will need at home?
• Will your health insurance cover all of your expenses? If not, what will and will not be covered?

Centers for Medicare and Medicaid Services website. Skilled nursing facility (SNF) care. www.medicare.gov/coverage/skilled-nursing-facility-snf-care. Accessed April 27, 2023.

Gadbois EA, Tyler DA, Mor V. Selecting a skilled nursing facility for postacute care: individual and family perspectives. J Am Geriatr Soc. 2017;65(11):2459-2465. PMID: 28682444 pubmed.ncbi.nlm.nih.gov/28682444/.

Skilled Nursing Facilities.org website. Learn about skilled nursing facilities. www.seniorcare.com/nursing-homes/. Accessed April 27, 2023.