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Post-acute care may provide options for people with cancer who are not able to return home after being in the hospital. There are several types of facilities that provide post-acute care. Each focuses on a specific type of care needed to help people regain their strength and ability to care for themselves.
Post-acute care is medical or supportive care given to a person who is leaving an acute care setting (such as a hospital) but is not ready to return to their home.
Post-acute care provides options for people who want to return home after a stay in an acute care setting but are not strong enough or not able to care for themselves yet. This can be especially helpful for people who do not have a family member or friend who can provide the hands-on care they need.
People who have developed short term disabilities or need care provided or supervised by doctors, nurses, or therapists (such as physical, occupational, or speech therapists) may find that a post-acute care setting can provide the needed services along with help doing activities of daily living.
Post-acute care has been shown to lower the chance that the person will end up in the emergency room or be readmitted to the hospital. It can also lower the chance that a person will need to be placed in a long-term care facility.
There are many reasons that people might need post-acute care after being in the hospital. This might include people who:
Cancer treatment can be very tiring and leave people weak, exhausted, and unable to take care of themselves. If you or a loved one are concerned about being able to return home safely, talk to your cancer care team about options.
The best option for post-acute care will depend on a person’s specific needs. There are five main types of post-acute care:
Many of these facilities do not provide cancer treatment. If a person needs to continue cancer treatment, someone from outside the facility may need to provide transportation to medical appointments and treatments.
Inpatient hospice may be a good option for people who are in the last phases of an incurable illness but whose care cannot be managed at home. Inpatient hospice care may be given in a designated hospice unit or facility or may be given in a skilled nursing facility (SNF).
Payment for post-acute care depends on the type of care being provided, the type of facility the person is in, and what type of insurance coverage they have.
Most private and government insurance will cover at least part of the cost of post-acute care if it must be given under the supervision of a doctor, registered nurse, or therapist. On the other hand, most insurance does not cover the cost of "custodial care," which focuses on helping people with bathing, eating, dressing, and similar activities of daily living.
Most government and private insurance will cover the cost of care at a skilled nursing facility. In many cases, the person must have been treated in a hospital for at least 3 days and discharged within the last 30 days.
Medicare and most private insurance plans will help pay for inpatient rehabilitation if certain criteria are met.
Most private and government insurance plans do not pay for nursing home care.
Most health insurance plans do not cover the cost of assisted living. Assisted living is considered "custodial care" and focuses on activities of daily living, such as bathing, dressing and eating.
Medicaid waivers are offered in some states and may cover some assisted living costs if care and financial requirements are met.
Because LTCHs provide similar services to acute care hospitals, most government and private insurance will cover the costs in the same way as hospitals. Certain requirements must be met, and the person must be either transferred directly from a hospital or have been discharged from a hospital in the last 60 days.
For some people who need long-term care that is not covered by their health insurance plans, long-term care insurance may be an option. However, this type of insurance can be expensive and often does not start paying right away. If you don't already have long-term care insurance, it may not be available if you have certain health problems or already need long-term care.
If you or a loved one needs continued care after leaving the hospital, the care needs and goals need to be defined. For instance:
Defining your post-acute care needs can guide the decision about which type of facility might be best. Input from the person with cancer, their family and caregivers, as well as the cancer care team will be needed. A physical therapist, social worker, discharge planner, case manager, or patient navigator can also help define needs and identify options for post-acute care.
Ask if your cancer center or hospital has staff who can help you find the best post-acute care options to meet your needs. There might be a social worker, discharge planner, case manager, patient navigator, or someone in a similar role.
Some questions you may want to ask to help in the search include:
You can also compare facilities to help guide your decision at medicare.gov/care-compare/.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.
American Hospital Association. Post-Acute Care Advocacy Alliance. Aha.org. Accessed at https://www.aha.org/advocacy/long-term-care-and-rehabilitation on June 3, 2022.
Fu JB, Raj VS, Guo Y. A guide to inpatient cancer rehabilitation: Focusing on patient selection and evidence-based outcomes. PM R. 2017; 9(9S2):S324-S334.
Medicaid. Long Term Services & Supports. Medicaid.gov. Accessed at https://www.medicaid.gov/medicaid/long-term-services-supports/index.html on June 3, 2022.
Medicare. What Medicare Covers. Medicare.gov. Accessed at https://www.medicare.gov/what-medicare-covers on June 3, 2022.
Veterans Administration. About VA Health Benefits. Va.gov. Accessed at https://www.va.gov/health-care/about-va-health-benefits/ on June 3, 2022.
Wang YC, Chou MY, Liang CK, Peng LN, Chen LK, Loh CH. Post-acute care as a key component in a healthcare system for older adults. Ann Geriatr Med Res. 2019; 23(2):54-62.
Yeh JC, Knight LS, Kane J, Doberman DJ, Gupta A, Smith TJ. Has there been a shift in use of subacute rehabilitation instead of hospice referral since immunotherapy has become available? Journal of Oncology Practice. 2019; 15(10): e849-e855.
Last Revised: July 15, 2022
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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