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Skilled Nursing Facility vs Inpatient Rehab Hospital

After surgery or a stroke, you'll be discharged to one of two settings. They look similar from the outside. The therapy intensity, medical oversight, and outcomes are different.

Side by side

Skilled Nursing Facility (SNF)Inpatient Rehab Hospital (IRF)
Therapy hours per day1-2 hours3+ hours
Daily MD visitsNo (weekly)Yes
RN coverageRequired, but lower ratios24/7 with higher ratios
Medicare coverageUp to 100 days, copay days 21-100Covered when criteria met
Average length of stay~25 days~12 days
Discharge to home rate~70%~80%
Best forRecovery that's expected to take longer with lower intensityPatients who can tolerate 3+ hours of therapy and need more medical supervision
If you can tolerate 3+ hours of therapy a day and need physician oversight, push for IRF. If you need more time and lower intensity, SNF is the right setting. The hospital's discharge planner often defaults to SNF; you have the right to ask for IRF if you qualify.

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Frequently asked

Can I choose where I'm discharged?

Yes. By federal law, the hospital must give you a list. You are not required to accept their first suggestion.

How do I know if I qualify for IRF?

Generally: you need to tolerate 3 hours of therapy a day, have realistic recovery goals, and need the level of medical supervision IRFs provide. Ask the hospital case manager for the IRF eligibility criteria.

What if the SNF therapist says I'm not making progress?

Medicare's 'maintenance therapy' rule means you don't have to be improving to keep getting therapy — you can be working to maintain function. Push back if a SNF discharges you for plateau.

Sources used on this page

Eldercare data on Palmelle is verified against authoritative sources. For deeper research: