Convalescent homes are designed to provide short term medical care for people who need assistance recovering from an injury, sickness, or surgery. They are not intended to be long-term care solutions nor primarily focused on assistance with activities of daily living.
Main Points
- Convalescent homes serve people who need significant medical care in their recovery from surgery, illness, or injury.
- Services provided include (but are not limited to) skilled 24/7 nursing care, meals, and therapy – such as physical therapy or occupational therapy.
- Services at a convalescent home are usually covered by Medicare, Medicaid, and private health insurance plans.
- Convalescent homes are often also referred to as Skilled Nursing Facilities.
- Convalescent home are different from nursing homes and assisted living facilities.
What is a Convalescent Home?
Convalescent homes are residential medical facilities intended to provide medical and skilled nursing care for residents who are typically recovering from a surgery, fall, or illness. Patients in convalescent homes are typically the elderly who frequently require medical care and monitoring after undergoing any health challenges and when family members cannot fulfill their medical needs. Additionally, residents often require short-term custodial care – or help with Activities of Daily Living (ADLs) such as getting dressed, toileting, bathing, cooking, etc.
Convalescent homes are often referred to as Inpatient Rehabilitation Facilities (IRFs) and Skilled Nursing Facilities (SNF). Roughly 60% of patients discharged from convalescent homes return home, while around 30% are admitted to long-term care facilities (which typically do not provide skilled medical care) or receive home health care.
When Do You Need a Convalescent Home?
Typically, people need to be accepted in a convalescent home during the period in which the body needs to heal from a severe disease, accident, or surgery. Changes in lifestyle and care from medical professionals may be required to ensure that the body is able to rest and receive proper care. According to Medicare, at least 60% of the patients admitted to a convalescent care center meet one or more of the following 13 criteria:
- Stroke
- Spinal cord damage
- Congenital malformation
- Amputation
- Multiple major traumas
- Hip dislocation
- Brain injury
- Burns
- Neurological illnesses
- Three types of arthritis
- Joint replacement
What Services are Provided at a Convalescent Home?
Convalescent care is a broad term which encompasses a wide range of care and therapy. Here are some examples of the type of care which is often received in a convalescent home:
- Offering occupational and physical therapy to assist the patient in regaining mobility and range of motion.
- Administering medication as directed by the patient’s physician.
- Providing nursing care or wound care as directed by doctors
- Offering psychological therapy to promote mental health and maintain a positive attitude.
- Providing speech therapy for patients who have trouble speaking.
- Preparing food for patients who cannot cook.
- Organizing social meetings and visits so that patients don’t feel lonely.
- Offering regular or occasional company.
- Transporting the patient to appointments.
- Assisting with the care of dependents or pets.
Is a Convalescent Home the Same as a Nursing Home?
Although there are some similarities between a convalescent home and a nursing home, they provide fundamentally different services and levels of care. They differ mainly in the level of care and the duration of the residency.
A convalescent care facility aims to get a patient healthy enough to go home. The aim is the same whether it takes thirty days or three months. Convalescent homes are designed for short-term recovery, with the objective getting elderly patients back to their home or a residential care facility.
On the other hand, nursing homes generally provide custodial care (sometimes called personal care). Nursing homes are similar to assisted living facilities where they primarily help with everyday activities and ADLs – some facilities will also offer medication management, social activities for residents, or minor medical care from on-staff nurses.
Although similar in name, nursing homes are different from skilled nursing facilities (which are similar to convalescent homes).
How Much Does a Convalescent Home Cost?
The financial factors of the senior’s stay are some of the most important things to consider while choosing a house. Because convalescent home stays are intended to provide short-term care, payments are billed daily rather than weekly or monthly.
Services at a convalescent home are usually covered by Medicare, Medicaid, and private health insurance companies.
According to the Medicare website, there will be some out-of-pocket expenses for convalescent home patients, but Medicare will cover everything for the first 20 days of the senior’s stay. Patients will be required to pay a daily copay (roughly $194.50 coinsurance per day) after 21 days through day 100
How to Pay for a Convalescent Home
As Medicare and Medicaid typically cover convalescent home care, provided it is a skilled nursing facility, qualifying senior patients typically have limited out of pocket expenses for short term stays.
- Medicare typically covers up to 100 days. The first 20 days are completely covered, while the remaining days are covered to roughly 80%.
- Medicaid covers the majority of services provided by convalescent facilities. However, each state has its own set of rules that must be followed. Contact your local Medicaid office for further information.
For patients who do not qualify for medicare, private health insurance plans will often cover short term stays in convalescent homes / skilled nursing facilities following hospitalizations when the facility is in-network. That said, you will need to verify the coverage of your specific plan.
