How Do I Choose a Rehab Location After Leaving the Hospital?

By Nikki Tyler

Sometimes a hospital stay is just the beginning.

If your loved one is hospitalized due to a fall, fracture, cardiac event or other unexpected medical incident, it’s likely they won’t go straight home. 

They may need a short-term stay in a skilled nursing facility for rehab or, in more severe situations, for long-term care.

For family members, the situation can be overwhelming. How do you decide where your loved one should go? What’s the process for getting them there? If you know the answers ahead of time, it can take some of the pressure off when anxiety is high.

The first step: Working with the hospital social worker. That’s who will help arrange your loved one’s placement after discharge. Speak frankly with the social worker about where you want your loved one to go; the decision is yours to make.

The social worker should ask for your top five choices. Families often consider location, reputation and past experience with the facility, among other factors when making their choices.

Note: You are not required to stay in the hospital’s system (i.e., the rehab center run by the hospital) unless that is your choice or no other option is available.

Based on your input, the social worker will send a referral to the locations of your choice. The referral includes the patient’s demographic information, insurance and financial disclosure, medical record from their hospital stay and other forms required by New York state.

The referral goes to the admissions departments at the locations you choose. (At St. Ann’s Community, that’s my department.) An admissions professional reviews the referral to determine whether they can accept the patient. That’s based on several factors, including their capability to meet the patient’s clinical needs; the availability of space; and their ability to accept the patient’s “payer source” (e.g., Medicaid, private pay, long-term care insurance).

Important: As your loved one’s advocate, it’s perfectly fine for you to call the admissions department at the facility you prefer and ask if they got the referral. If they didn’t, notify the hospital social worker. It never hurts to make that personal contact with admissions and give them a heads-up that a referral is coming.

If any or all of your top five choices accept the referral, their admissions team will notify the hospital social worker, who will notify you. If more than one accepts, you can choose the one you prefer. Arrangements will then be made for your loved one to be moved there upon discharge.

What if you don’t get your first choice or even one of your top three? Continue advocating for your loved one by asking the social worker why the referral was denied. There may be legitimate reasons, but it never hurts to stay involved in the process and have your questions answered to your satisfaction. It’s a big decision, and your loved one is depending on you.

The reality is your loved one may not qualify for your first-choice location. It’s unfortunate and understandably frustrating, but space may simply not be available or other factors may not be met. The hospital social worker will help get your loved one the best care possible within the available options.

We’ve been discussing emergency hospitalizations, but I want to add something: If your loved one’s hospital stay is a planned one (such as a surgical procedure they’ve scheduled in advance), contact the admissions team at the rehab site of your choice and pre-plan their stay. That way, you’ll have that decision made ahead of time, ensuring that a room is reserved. Be sure to let the hospital social worker know you’ve pre-planned. You and your loved one will be glad you did!


Nikki Tyler is senior admissions professional at St. Ann›s Community. She can be reached at 585-697-6507 or at ntyler@mystanns.com.