Sub Acute Rehab Vs Skilled Nursing Facility

When a patient enters a skilled nursing or subacute rehab facility, they need a specific type of nursing care. Maybe you’re a nurse who would like to apply for a job at one of these two, but aren’t sure of the differences, or maybe you’re even a patient or a loved one! Let’s walk through some of the differences between the two.

Please note, we will focus on information applicable to the RN who is considering a job at one of these facilities. After all, this is a blog for nurses!

What is Sub Acute Rehab?

In a nutshell, a Sub Acute Rehab facility is like a bridge that helps people transition from a hospital stay to homes. “Acute care” basically means care provided in the hospital setting. “Sub Acute Rehab” means a step down from the hospital, so “below hospital level of care”.

Translation: You’re not sick enough to need constant care from nurses in the hospital, but you’re not well enough to be at home and just go to outpatient physical/occupational/speech therapy appointments.

These rehab centers specialize in providing short-term rehabilitation services, focusing on a variety of therapies and care programs to help patients regain their strength and independence. These are often things like physical and occupational therapy, as well as speech therapy (and possibly others).

The ultimate goal? To get patients back to to their baseline or new optimal level of functioning and independence. The average length of stay for patients in sub acute rehab tend to be one to several weeks.

Primary Function of Sub Acute Rehab

Sub Acute Rehab facilities provide a unique mix of medical, nursing, and therapy services tailored to each patient’s individual needs. The dream team of healthcare professionals includes physical therapists, occupational therapists, speech therapists, and nurses, all working together to create a customized plan for recovery.

What sets Sub Acute Rehab facilities apart from other types of rehab centers is the intensity and duration of the care provided. The care is less intensive than an acute rehab facility (hence the name ‘sub’ acute), but more intensive than the care you’d receive at a skilled nursing facility or at home. Patients typically receive therapy services for about one to three hours a day, five to seven days a week.

Patients who enter sub acute rehab facilities tend to be ones who have more complex needs that will take time to heal.

A great example of a prime candidate for sub acute rehab is a 28-year-old recovering from a motor cycle accident. Let’s say this patient had to have multiple orthopedic surgeries during their hospital stay to fix broken bones, has a few complex wounds that require specific care, long term IV antibiotics, and nutritional deficiencies. A patient like this who has recovered from surgery isn’t sick enough to stay in the hospital for the next 3-4 weeks for IV antibiotics, wound care, support from a dietician, and intensive physical and occupational therapy. A patient like this doesn’t need daily visits from a physician like all hospitalized patients, because the plan of care isn’t changing every 24-hours. Their plan is more long-term and stable than someone in the hospital who requires reassessment by a physician every day.

It would make a lot more sense to send this very stable patient to a different facility that is focused on more intense short-term recovery that isn’t as loud and busy as a hospital, waking patients up repeatedly at night, updating the plan of care on a daily basis. Therefore, once medically stable, these patients can get transferred to Sub Acute Rehab!

Are Sub Acute Rehab Facilities Just for Elderly People?

A common misconception about Sub Acute Rehab facilities is that they cater exclusively to the elderly population. While it’s true that older adults often utilize these services, they are by no means the only ones who can benefit from them. Sub Acute Rehab facilities are designed to accommodate individuals of all ages who require assistance in their recovery process following a hospital stay.

Whether you’re a young adult recovering from serious car accident, a middle-aged person dealing with a major complication after surgery, or an older adult facing a health issue, Sub Acute Rehab centers offer a range of services and therapies to meet your specific needs. The goal is to help patients of all ages regain their strength and independence, so they can return to their daily lives with confidence.

Essentially, Sub Acute Rehab facilities are not just for the elderly, but for anyone who needs specialized care and support on their path to recovery, regardless of their age.

What is Skilled Nursing Care?

A Skilled Nursing Facility is a dedicated care setting for individuals who require long-term care or support due to chronic health conditions, disabilities, or age-related issues. These facilities provide round-the-clock medical attention and assistance with daily activities, with the goal of maintaining their residents’ overall health and well-being.

What distinguishes Skilled Nursing Facilities from other types of care centers is the level of care provided. These facilities offer 24-hour nursing care, which includes medication management, wound care, and monitoring vital signs. Additionally, they provide assistance with activities of daily living (ADLs), such as bathing, dressing, and eating, to ensure residents receive the support they need.

Beyond meeting basic needs, Skilled Nursing Facilities often provide additional services like physical, occupational, and speech therapy. They also offer social and recreational activities to foster a sense of community and engagement among residents.

What’s an LTACH, SNF, and IRF?

Long-Term Acute Care Hospitals (LTACHs)

LTACHs are specialized hospitals designed to provide care for patients with complex medical conditions who require a longer hospital stay, typically exceeding 25 days. Patients in LTACHs usually suffer from multiple acute or chronic illnesses and need continuous, high-level medical care. Examples of patients in LTACHs include those on prolonged ventilator support, those with severe wound care needs, or patients with multiple organ failure.

Key features of LTACHs:

1. Provide long-term acute medical care and management.
2. Focus on patients with complex medical conditions.
3. Offer continuous, high-level medical care, including intensive care unit (ICU)-level services.

Skilled Nursing Facilities (SNFs)

SNFs are care facilities that provide long-term care or short-term rehabilitation services for patients who need 24-hour nursing care and assistance with daily activities. These facilities cater to individuals with chronic health conditions, disabilities, or age-related issues. SNFs provide a range of services, including medication management, wound care, and therapy services such as physical, occupational, and speech therapy.

Key features of SNFs:

1. Offer long-term care or short-term rehabilitation services.
2. Provide 24-hour nursing care and assistance with activities of daily living.
3. Deliver additional services like therapy and social activities.

If you’re a nurse who is interested in working in ICU one day but want to ease into it, starting off at an LTACH would be a great first step.

Inpatient Rehabilitation Facilities (IRFs)

IRFs are specialized facilities that provide intensive rehabilitation services to patients recovering from severe illnesses, injuries, or surgeries. The goal of an IRF is to help patients regain their independence and functionality. Patients in IRFs typically require a high level of rehabilitation services, receiving at least three hours of therapy per day for five to seven days a week. Examples of patients in IRFs include those recovering from strokes, spinal cord injuries, or amputations.

Key features of IRFs:

1. Focus on intensive rehabilitation services.
2. Help patients regain independence and functionality.
3. Require a high level of therapy services, with patients receiving at least three hours of therapy per day.

Note: Inpatient Rehab and Sub Acute rehab are different, even though they both have “rehab” in the name. IRF patients have a shorter length of stay than Sub Acute. IRFs focus on more intensive rehabilitation for patients with severe conditions (spinal cord injuries, strokes, amputations, traumatic brain injuries), while Sub Acute Rehab Facilities offer less intensive, short-term rehabilitation services for a wider range of patient conditions (cardiac events, ortho surgeries, pulmonary issues).

Basically, LTACHs, SNFs, and IRFs each serve distinct patient populations and provide different levels of care. LTACHs focus on long-term acute care for complex medical conditions, SNFs offer long-term care or short-term rehabilitation services with 24-hour nursing support, and IRFs provide intensive rehabilitation services to help patients regain their independence and functionality.

What’s the Difference? Sub Acute Rehab Vs Skilled Nursing Facility

So, what are the big differences between these two from a nursing perspective.

Complexity of Medical Care

Skilled Nursing Facility

In an SNF, you will typically encounter patients who require long-term care or rehabilitation services due to chronic health conditions, disabilities, or age-related issues. The complexity of medical care in SNFs can vary, but the focus is primarily on maintaining patients’ overall health and well-being. You’ll manage medications, monitor vital signs, provide wound care, and address any changes in patients’ health status.

Sub Acute Rehab Facility

In a Sub Acute Rehab Facility, the complexity of medical care is generally higher than in an SNF, as patients need short-term, specialized care following a hospital stay. They are often recovering from surgery, injury, or illness and require close monitoring and medical interventions. As a nurse, you’ll collaborate with a multidisciplinary team and manage a diverse range of clinical tasks, including administering medications, managing IVs, and providing wound care.

Common Patient Types

Skilled Nursing Facility

Patients in SNFs usually need long-term care due to chronic health conditions, disabilities, or age-related issues. You’ll encounter a diverse patient population, including those with dementia, Parkinson’s disease, or stroke, as well as patients recovering from joint replacement surgeries or managing chronic illnesses like diabetes or heart failure.

Sub Acute Rehab Facility

Patients in Sub Acute Rehab Facilities are typically recovering from surgeries, injuries, or illnesses and require short-term, specialized care. Examples include patients recovering from orthopedic surgeries, cardiac events, or pulmonary issues.

Staffing

Skilled Nursing Facility

In an SNF, you’ll work closely with a team of healthcare professionals, including physicians, therapists, and dietitians. As a nurse, you’ll play a vital role in coordinating care, developing care plans, and ensuring patients receive the support they need.

Sub Acute Rehab Facility

In a Sub Acute Rehab Facility, the staffing is a bit more interdisciplinary, as you’ll collaborate with physical therapists, occupational therapists, speech therapists, and other healthcare professionals with a continually evolving plan of care. You’ll be responsible for coordinating with this team to provide comprehensive care for patients during their recovery.

Level of Therapy

Skilled Nursing Facility

The level of therapy in SNFs is less intensive compared to Sub Acute Rehab Facilities. Patients may receive therapy services as needed, but the primary focus is on providing ongoing nursing care and maintaining patients’ overall health and well-being.

Sub Acute Rehab Facility

The level of therapy in Sub Acute Rehab Facilities is more intense, as patients require specialized rehabilitation services to regain strength and independence. Patients typically receive therapy for one to two hours per day, for five to seven days a week.

Length of Stay

Skilled Nursing Facility

The average length of stay in an SNF is typically longer, as patients often require ongoing care and support for an extended period. This can range from months to even years, depending on the patient’s unique needs and progress.

Sub Acute Rehab Facility

In contrast, the average length of stay in a Sub Acute Rehab Facility is shorter, as patients receive focused, short-term care to facilitate their recovery. The length of stay can range from one week to several weeks, depending on the patient’s progress and specific needs.

Ultimate Goal

Skilled Nursing Facility

The big picture goal for patients at a skilled nursing facility is maintaining their health status and prevention of compilations.

Sub Acute Rehab Facility

The big picture at sub acute rehab is to recover and return home ASAP.

Conclusion

While these two nursing specialties seem similar, there are pretty big differences between the two. Patients in both of these areas can be complex, but they are more stable and have a much more consistent care plan than hospitalized patients. Working in one of these areas is great for nurses who are interested in providing direct patient care and forming long-term therapeutic relationships with patients but don’t want to work in the hospital environment.

If you’re interested in applying at one of these facilities, check out our 3-pack of nurse resume templates and nursing job interview questions.

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