In general, Medicare Part A will pay for Transitional Care if a patient meets the following criteria:
- The visit must be linked to an acute 3-night hospital stay in the last 30 days
- The patient must require inpatient skilled nursing or therapy services on a daily basis under the supervision of healthcare professionals.
Medicare will cover the first 20 days at 100% with a co-pay required for additional service days as needed. Many commercial insurances, as well as, Medicare HMOs, also offer transitional care (swing bed) benefit, which would need to be verified by the hospital prior to admission to a Valley Health Transitional Care program.
A patient can stay in a Valley Health Transitional Care program as long as they are making clinically meaningful progress as determined by the interdisciplinary care team in conjunction with the insurance benefit guidelines. The average length of stay for a transitional care patient at Valley Health is 8-14 days. Upon completion, patients will be discharged to one of the following:
- Home with no follow-up services
- Home with home health for nursing and/or rehabilitation services
- Home with an order for outpatient rehabilitation services
- Assisted living facility
- Skilled nursing or long term care facility
- Home with hospice
For the safety of our patients, visitors, staff and the broader community, visitation hours may vary. Please click here for the most current visitation guidelines.
