Guide

Short-term rehab after the hospital: how to make the most of it

Updated October 15, 2026 · Reviewed against official sources

Many families simply call it "rehab." This guide focuses on the stay itself.

Coverage basics in one paragraph

Original Medicare pays for the stay if your loved one was admitted as an inpatient for at least 3 days in a row (days under observation don't count), generally enters the facility within 30 days after leaving the hospital and needs daily skilled care. In 2026, days 1 to 20 cost $0 (the $1,736 Part A deductible has usually already been paid at the hospital during the same benefit period); days 21 to 100 cost $217 a day; and from day 101 on, the person pays everything. Details and exceptions are in what Medicare covers and hospital discharge; if discharge is tomorrow, see urgent help. The stay includes a semi-private room, meals, nursing care, physical, occupational and speech therapy, medications and supplies.

Skilled nursing facility or rehab hospital

An inpatient rehabilitation facility (rehab hospital) is for people who need intensive therapy and ongoing medical supervision; Medicare pays for it like a hospital stay. Ask the hospital team which of the two they recommend and why.

How to choose a rehab facility

The hospital must give you a list of available facilities in the area you ask for, and the choice is yours. The hospital social worker can help you with the list and with finding open beds.

What to look at in Care Compare

In Medicare's Care Compare, these facilities are listed as Nursing homes including rehab services. Besides the star ratings, there are measures designed for short stays, for example:

• What percentage of patients successfully return home or to the community.
• How many go back to the hospital or to the emergency room within 30 days after admission.
• How many leave with the expected ability to take care of themselves and move around.
• How many develop new or worsening pressure ulcers (bedsores).

On each listing in our senior living directory, you'll see the short-stay (rehab) rating along with inspections. You can put several facilities side by side with compare and learn how to read it all in how to read Medicare star ratings. A number is a snapshot of one moment: use it to prepare your questions.

Questions about therapy

• How many days a week does a patient like my loved one get therapy, and how long is each session?
• Are there physical, occupational and speech therapists at the facility? Do they work on weekends?
• Where is therapy done? Do you have a gym or a space to practice stairs, the bathroom or the kitchen?
• Are there therapy or nursing staff who speak Spanish?
• How often does the doctor come by? How and when do you update the family?
• If your loved one has Medicare Advantage: is the facility in the plan's network?

Bring our visit checklist if you can stop by the place, even just once.

Being close by matters too

A facility close to the person who will visit most makes it possible to sit in on some sessions and learn how to help with transfers before going home.

The first few days

• Within 48 hours, the facility must have a baseline care plan, and your loved one or their representative gets a summary.
• Within the first 14 days, a full assessment is done with the CMS tool (the MDS), and the full care plan is prepared within the next 7 days.
• The therapists evaluate your loved one and set specific goals: walking to the bathroom, climbing the front steps, getting dressed while sitting down.

Tell the team what the home is like (stairs, bathroom, who lives there) and what your loved one used to do before. Ask for the care plan meeting and ask about the discharge plan from the start: federal law requires the facility to prepare it with the resident and their representative, to take into account who will be able to help at home and, when the resident leaves, to review their medications.

Your loved one doesn't have to "get better" to keep coverage

Sometimes families hear that the person has "plateaued" and that coverage is ending because of it. Since the Jimmo v. Sebelius court settlement, approved in 2013, CMS has made clear that coverage for skilled nursing and skilled therapy doesn't depend on whether the person can improve, but on whether they need skilled care, including care to maintain their condition or keep it from getting worse. This applies in a SNF, in home health care and in outpatient therapy. All the other rules still apply, and Medicare doesn't cover care that someone without special training could safely provide.

If you're told therapy is ending because "there's no more progress," you can kindly ask: "Does my mom still need skilled therapy to maintain her condition?"

When Medicare stops paying: the notice and the fast appeal

1. The facility must give you a written notice called the Notice of Medicare Non-Coverage (NOMNC) at least 2 days before covered services end. If you don't get it, ask for it.
2. If you think it's too soon, ask for a fast appeal from the independent organization for your region (the BFCC-QIO), following the instructions on the notice, no later than noon of the day before the end date shown on it.
3. The QIO makes its decision by close of business the day after it gets the information it needs.
4. If the QIO agrees with the facility, your loved one doesn't pay for services received before the date on the notice; the days after that may be at your own cost.

This applies to both Original Medicare and Medicare Advantage. If you miss the deadline, there are still options (with Medicare Advantage, a fast reconsideration by the plan). This notice isn't used when the 100 days simply run out.

Appealing is a normal step, not a fight: it's asking for an independent second opinion.

If your loved one has Medicare Advantage

• The plan may not require the 3 hospital days, but it may charge copays starting in the first 20 days and use a network of facilities.
• Plans may require prior authorization. Since 2024, under a CMS rule, they must follow the same coverage criteria as Original Medicare, and an approval must stay valid as long as the treatment is medically reasonable and necessary.
• Since January 1, 2026, plans must respond to prior authorization requests within 72 hours if urgent and within 7 calendar days if not, and give a specific reason if they deny it.

If the plan denies or shortens the stay, use its appeal process and ask for it to be fast. Medicare (1-800-633-4227) and your state's SHIP program (shiphelp.org) give free guidance.

What comes after rehab

Going home

• Home health care: if your loved one is homebound and needs nursing or therapy on an intermittent basis, Medicare pays for it at no cost to them. Look for agencies in our home health agency directory.
• Medical equipment (walker, wheelchair, hospital bed): Part B covers it with a prescription for use at home; after the $283 deductible in 2026, you pay 20% of the Medicare-approved amount, using suppliers enrolled in Medicare.
• Daily help with bathing or dressing: Medicare doesn't pay for it if that's the only help needed. See home care agencies, the calculator and how to adapt the home.

Staying long term

If going home isn't safe, your loved one can often stay in the same building as a long-term resident, paying privately or with Medicaid. Start the application early. Other options are assisted living, small residential care homes and the PACE program.

💬Frequently asked questions

Will my loved one stay all 100 days?

Not necessarily. The 100 days are a maximum per benefit period: coverage continues as long as your loved one needs daily skilled care.

Can we switch facilities during rehab?

You can ask for a transfer. It depends on another facility having a bed and, with Medicare Advantage, on the plan's network. First, talk with the team and the social worker: many concerns get resolved at the care plan meeting.

This guide is for information only and is not medical or legal advice. Rules can vary depending on your loved one's plan.

Sources

• Medicare.gov, Skilled nursing facility care: https://www.medicare.gov/coverage/skilled-nursing-facility-care (accessed October 15, 2026)
• eCFR, 42 CFR 482.43, discharge planning in hospitals: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-482/subpart-C/section-482.43 (accessed October 15, 2026)
• CMS, 2026 Medicare Parts A & B Premiums and Deductibles: https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles (accessed October 15, 2026)
• Medicare.gov, Inpatient rehabilitation care: https://www.medicare.gov/coverage/inpatient-rehabilitation-care (accessed October 15, 2026)
• CMS, Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide (September 2026): https://www.cms.gov/medicare/provider-enrollment-and-certification/certificationandcomplianc/downloads/usersguide.pdf (accessed October 15, 2026)
• eCFR, 42 CFR 483.20, resident assessment: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-B/section-483.20 (accessed October 15, 2026)
• eCFR, 42 CFR 483.21, care planning and discharge planning: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-B/section-483.21 (accessed October 15, 2026)
• CMS, Jimmo Settlement: https://www.cms.gov/medicare/settlements/jimmo (accessed October 15, 2026)
• Medicare.gov, Fast appeals: https://www.medicare.gov/providers-services/claims-appeals-complaints/appeals/fast-appeals (accessed October 15, 2026)
• CMS, Form Instructions for the Notice of Medicare Non-Coverage (NOMNC) CMS-10095: https://www.cms.gov/Medicare/Appeals-and-Grievances/MMCAG/downloads/nomncinstructions.pdf (accessed October 15, 2026)
• CMS, 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F): https://www.cms.gov/newsroom/fact-sheets/2024-medicare-advantage-and-part-d-final-rule-cms-4201-f (accessed October 15, 2026)
• CMS, Interoperability and Prior Authorization Final Rule (CMS-0057-F): https://www.cms.gov/newsroom/fact-sheets/cms-interoperability-prior-authorization-final-rule-cms-0057-f (accessed October 15, 2026)
• Medicare.gov, Home health services: https://www.medicare.gov/coverage/home-health-services (accessed October 15, 2026)
• Medicare.gov, Durable medical equipment (DME) coverage: https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage (accessed October 15, 2026)

This is general information, not medical, legal or financial advice. Rules vary by state and by year: confirm with the official agency that applies to you.

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