Subacute care is medical and skilled nursing services provided to patients on an inpatient basis who are not in an acute phase of illness or injury but who require a level of care higher than that provided in a long term care setting.
The goal is usually to discharge to home, however, sometimes the goal will be to discharge to a lesser level of care.
In the State of Wisconsin, Subacute centers are licensed the same as nursing homes. Their rules and regulations are the same. They are inspected by the same State Inspectors who inspect nursing homes for the Department of Health And Family Services, Bureau of Quality Assurance on an annual basis.
Depending upon the facility that offers subacute care, they will have developed a separate Philosophy that addresses their commitment and ability to provide a higher level of care.
Paying for care: Medicare (T 18), Medicaid (T19), Veteran's benefits, private insurance and personal assets are used depending upon various circumstances.
Selection of a Subacute center:
All persons entering a subacute facility must do so by order of their physician. Residents have the right to designate a personal physician of their choice. Unfortunately, not all physicians will follow their patients. It is important to determine whether or not his or her physician will continue treatment after admission. If not, the resident may select a physician from among those who practice at the facility or those who would be willing to practice in facility. You may continue to see a physician outside of the facility. The State Regulations can be found online at the Department of Health and Family Services: http://www.dhfs.state.wi.us Please, consult the Nursing Home Regulations HFS 132.61 Medical Services (2) for more information.
Using the skilled care / nursing home search options available to you here on this web site, select your desirable geographic location, special need of subacute care and develop a list of possibilities.
Call the facilities and screen for ability to provide the care needed, will they accept the insurance or payment source and do they have an opening.
The facility will determine acceptance of the patient based upon an assessment. Some facilities do an onsite assessment.
If the facility sounds appropriate, make an appointment to visit.
When touring the facility Look, Listen, Smell and Ask Questions. You may want to use the detailed check off list for touring a nursing home, (click here for the list) keeping in mind subacute care has an emphasis that is more medical than some of the other levels of care and there may be a different atmosphere.
Find out about the facilities on the list. Currently there is no official public rating but they are inspected yearly. Contact our office at (414) 291-7500 for a summary of the State Inspection reports.
After the placement:
After admission a care plan will be developed by all appropriate disciplines (i.e. departments of Nursing, Therapy, Dietician, e.t.c.), based on history, assessments, physicians' evaluations and orders. There will also be a care plan conference. This is an opportunity for the patient and family to raise specific concerns that need to be addressed. You may also learn the daily routine as well as who to speak to regarding the various aspects of care.
The State requires the facility to provide you with a "Resident's Bill of Rights". Read these and understand who to speak to if there is a problem or a concern.
Remember that the Federal Guideline requires a person to be in the "least restrictive" setting based on needs. The subacute center may discharge a person for a number of reasons, into a rehabilitation program as well as into another level of care. These alternatives may be at the same facility, at another facility or even at home.
If you have any questions regarding subacute care you may call the Department of Health And Family Services, Bureau of Quality Assurance in Milwaukee at (414) 227-5000.
If you have problems with the facility you may want to speak to a professional advocate called an 'Ombudsman". They are available at BOARD ON AGING & LONGTERM CARE OMBUDSMAN PROGRAM:
Milwaukee Office: (414) 227-4386
Statewide: 1-800-815-0015