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What is Subacute Nursing Home Care?

For patients who have suffered an injury, illness or exacerbation of a disease, subacute nursing home care can offer a money-saving alternative to in-hospital care. Subacute care differs from that of a traditional nursing facility in that it provides more intensive care to the patient until the condition is stabilized.

Generally, the patient is assigned a medical team, which comes up with a treatment plan. For example, the Elderwood Senior Care facility in Western New York says they offer a comprehensive team of professionals including, "physical and occupational therapists, speech and language pathologists, dietitians, nursing and medical professionals, and a trained social worker available for counseling and case management."

Typically, short-term subacute nursing home care is designed to return patients to the community or transition them to a lower level of care. Treatment is goal-oriented and time-limited. A complex team of medical professionals assesses the goals for treatment in regard to aid for any of the following:

     
  • Post-surgical care
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  • Continued medical care (medically complex)
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  • Infusion therapy
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  • Wound care
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  • Pain management
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  • Ventilator care and weaning

A main concern for subacute nursing home care providers is that patients coming to them from acute hospital care are often malnourished. A study conducted by a team of physicians from the St. Louis Health Sciences Center showed that 40% to 60% of patients hospitalized for acute illness are malnourished and the condition worsens the longer the stay. They recommend strict attention to nutritional needs in subacute care settings. That means reliable subacute nursing homes aim to improve the total health of the patient, and not just the illness or the injury.

The value of subacute nursing home care

Case studies have shown that the costs of subacute nursing home care are significantly less than hospital or traditional rehabilitation centers. For example, a patient requiring ventilator treatment and coma stimulation would cost more than $1,000 per day in a rehabilitation unit of a hospital. The same care at a subacute facility would cost $500 per day. Over time, this represents a significant cost savings for patients and insurance companies.

In fact, the California Association of Health Facilities says,

“Compared to $700 to $1,000 per day for a hospital stay and $850 per day for a rehabilitation hospital, a nursing facility subacute unit generally runs $300 to $550 per day or less, depending on the patient’s needs.”

Furthermore, Medicare and private insurance are the primary source for subacute nursing home care funding. Medicare pays 68% while private insurance and individuals account for 22%, with the remainder coming from other sources such as the patient or his or her family.

In summary, subacute nursing home care offers patients the chance to heal without the high cost of an extended hospital stay. Best of all, there are resources, such as Medicare, that can help negate the expense.



     
  • Medicare and private insurance are the primary payers for subacute care, with Medicare paying the greatest portion (68%), individuals and private insurance accounting for 22%, and the remaining 10% coming from other payer sources. (Source: 1996 Facts and Trends study from the American Health Care Association)
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  • Compared to a hospital stay, a nursing facility subacute unit generally costs $300 to $500 less per day, depending on the patient’s needs. (Source: California Association of Health Facilities)
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  • 40% to 60% of patients hospitalized for acute illness are malnourished, and nutritional status has been shown to deteriorate in these patients after hospital admission. (Source: American Journal of Clinical Nutrition)