To qualify for Medicare-covered care in a rehabilitation hospital, your physician must certify that you need this type of intensive rehabilitation (this care is medically necessary).
- For it to be considered medically necessary, you must require all of the following services to ensure safe and effective treatment:
- 24-hour access to a physician (meaning you require frequent, direct physician involvement, at least every 2-3 days)
- 24-hour access to a registered nurse with specialized training or experience in rehabilitation
- intensive therapy, which generally means at least three hours of therapy per day (but exceptions can be made on a case by case basis—you may still qualify if you are not healthy enough to withstand three hours of therapy per day).
- a coordinated team of providers including, at minimum, a physician, a rehabilitation nurse and one therapist.
Your condition must be expected to improve enough from a stay in a rehabilitation hospital to allow you to function more independently. For example, therapy may help you regain the ability to perform “activities of daily living” on your own (such as eating, bathing and dressing) or live at home or with family rather than in a living facility.