What is subacute care?

Subacute care is goal-oriented, comprehensive, inpatient care for the medically complex patient who has had an acute illness, injury, or the exacerbation of a chronic disease. This care is rendered immediately after or instead of acute hospitalization.

Subacute care settings provide the opportunity for the patient to receive complex care or treatment with a focus on rehabilitation or return to prior level of function. The subacute program provides a new level of care within the care continuum in a cost-effective manner.

The subacute program can be provided in a specialty unit or SNF wing of an acute hospital in a designated and licensed SNF unit of an acute rehab hospital, or in a freestanding skilled nursing facility. Regardless of the location, the program provides care using an interdisciplinary approach to meet the needs particular to the subacute patient.

The subacute staff is made up of highly skilled professionals such as physicians, nurses, and therapists and qualified support personnel such as nursing assistants, therapy aides, and technicians. Because of the range of staffing expertise, subacute care has been defined as being more intensive than traditional nursing home care, but less intensive than acute hospital care.

Admission criteria for the program include a wide spectrum of patient care needs. These include, at a minimum, twenty-four hour care directly supervised by an RN and the administration of intensive therapies or treatments. These needs can consist of TPN, extensive, complex wound care, psychosocial interventions and support, and extended rehabilitation programs.

The length of stay can range from 20 to 100 days or longer, depending on the complexity of the patient's condition and the length of time for stabilization or completion of the pre-determined treatment plan.

The regulations and standards governing the subacute program are the same as those that are applicable to the skilled level of care - OBRA, JCAHO Standards for Long Term Care and Subacute, and any individual state program requirements such as Medicaid/Medi-Cal.

Funding sources include Medicare, private insurance/HMOs, and Medicaid/Medi-Cal in some states.