Where Can a Patient Discharge After a Skilled Nursing Facility if They Can’t Go Back Home?
For many patients, a stay in a skilled nursing facility (SNF) is a temporary step in their recovery journey. Whether they were hospitalized for surgery, illness, or injury, SNFs provide necessary rehabilitation and medical care before a patient can safely return home. However, not all patients regain the level of independence needed to live alone or return to their previous living situation. When going home isn’t an option, families and caregivers must explore alternative discharge destinations that offer the right level of support, care, and quality of life.
Here’s a look at the different care settings available for patients who can’t return home after a skilled nursing facility stay.
Assisted Living Facilities (ALFs)
Best for: Patients who need help with daily activities but not 24/7 medical care
Assisted living facilities provide a balance between independence and support. They offer:
- Private or semi-private apartments
- Assistance with activities of daily living (ADLs) such as bathing, dressing, and medication management
- Social activities, dining services, and community engagement
- Access to healthcare providers for minor medical needs
Who should consider this option?
Patients who can walk (or use mobility aids), need some supervision with medications, or require minor assistance with personal care but don’t need round-the-clock nursing.
Financial Considerations:
- Medicare does not cover assisted living.
- Medicaid may help in some states through waiver programs.
- Private pay, long-term care insurance, or veterans’ benefits may assist with costs.
Long-Term Care Nursing Homes
Best for: Patients who need 24/7 skilled nursing care
Unlike short-term rehabilitation at an SNF, long-term care nursing homes provide ongoing medical supervision for chronic conditions, disabilities, or severe mobility limitations. Services include:
- 24-hour nursing care
- Assistance with all ADLs
- Management of chronic conditions (e.g., dementia, severe arthritis, stroke recovery)
- On-site therapy services
Who should consider this option?
Patients who have complex medical needs, require assistance with all basic daily activities, or need continuous medical supervision.
Financial Considerations:
- Medicare only covers short-term stays after a hospital discharge.
- Medicaid can cover long-term nursing home care for eligible low-income patients.
- Private pay, long-term care insurance, or veterans’ benefits may help with costs.
Memory Care Facilities
Best for: Patients with Alzheimer’s or dementia who need specialized care
Memory care units, often part of assisted living or nursing homes, provide:
- Secure environments to prevent wandering
- Staff trained in dementia care
- Structured routines to reduce confusion and agitation
- Medication management and behavioral therapy
Who should consider this option?
Patients with moderate to severe dementia or Alzheimer’s who need supervision and specialized care.
Financial Considerations:
- Medicare doesn’t cover memory care housing.
- Medicaid may cover costs if the patient qualifies for long-term care assistance.
- Private pay and long-term care insurance are common funding sources.
Residential Care Homes (Board and Care Homes)
Best for: Patients who need a home-like setting with basic care
Residential care homes, also called board and care homes, provide:
- Private or shared rooms in a small, home-like setting
- Assistance with ADLs
- Meals, housekeeping, and limited medical care
Who should consider this option?
Patients who don’t require intensive medical supervision but need help with daily tasks and prefer a smaller, quieter environment.
Financial Considerations:
- Costs vary but are typically private pay.
- Medicaid may help in some states through waiver programs.
Hospice or Palliative Care Facilities
Best for: Patients with a terminal illness who require comfort care
Hospice and palliative care facilities focus on:
- Pain and symptom management
- Emotional and spiritual support
- Comfort-focused, end-of-life care
Who should consider this option?
Patients with a terminal prognosis (typically six months or less to live) who choose comfort over curative treatments.
Financial Considerations:
- Medicare, Medicaid, and most private insurance plans cover hospice care.
Group Homes for Medically Complex Patients
Best for: Patients with disabilities or chronic medical conditions needing ongoing care
These small, community-based homes provide:
- 24/7 supervision by trained caregivers
- Medical oversight
- ADL assistance and community integration opportunities
Who should consider this option?
Patients with lifelong disabilities, traumatic brain injuries, or chronic conditions that require long-term care in a non-institutional setting.
Financial Considerations:
- Medicaid may fund group home placement.
- Private pay and disability benefits can also contribute.
Continuing Care Retirement Communities (CCRCs)
Best for: Patients who want a full spectrum of care in one place
CCRCs provide:
- Independent living, assisted living, and skilled nursing on one campus
- The ability to transition between levels of care as needs change
- A vibrant community with social activities
Who should consider this option?
Patients who want to plan for long-term aging without having to move between different facilities.
Financial Considerations:
- CCRCs often require a significant upfront entrance fee plus monthly costs.
- Private pay, long-term care insurance, and veterans’ benefits may help.
Final Thoughts: Choosing the Right Discharge Option
Selecting the right discharge destination depends on the patient’s medical needs, level of independence, financial situation, and personal preferences. It’s important for families to:
- Consult with discharge planners or social workers at the skilled nursing facility.
- Tour potential facilities to assess their quality of care.
- Consider financial resources and long-term affordability.
- Plan ahead to ensure a smooth transition.
When home is no longer an option, these alternatives provide safe, supportive environments where patients can continue their recovery and live with dignity and care.
Have more questions, feel free to Contact Us for assistance!