Geriatrics Rehabilitation at Home (RaH)

Following a traditional hospitalization, you or your family member may be admitted to a rehabilitation or skilled nursing facility in order to continue to recover from an illness or surgical procedure before returning home. This form of treatment is called sub-acute rehabilitation. Some patients may prefer to return home immediately, with the proper support and services in place.

The Rehabilitation at Home program admits patients who are usually recommended for the program by inpatient physical therapists, social workers, or discharge planners. Rehabilitation at Home is available to patients with appropriate insurance coverage and live in the areas of New York City covered by the program. Patients must also have sufficient home support to manage at home during this recovery period.

An individualized care plan is created for each patient that can include:

Access to nurses who will monitor health status, communicate with doctors, and answer any medical questions
Lab services, IV medications, and other equipment or therapy brought directly to the home
On-call service—24 hours a day, seven days a week—to respond to any urgent or immediate needs
Regular visits from home care nurses from home health agencies to check vital signs and administer certain medications, including infusions
Rehabilitation services by physical therapists, occupational therapists, and speech therapists from home health agencies as ordered by your doctor
Care coordination to develop a follow-up plan as needed

Service intensity varies depending on the needs of the patient and may range from daily clinician communication for high-risk patients to weekly check-in telephone calls for regular-risk patients whose conditions are stable or improving. The program arranges all of these services from the providers involved in the care plan for approximately 15 days with your Rehabilitation at Home follow-up and for up to 60 days depending on the individual insurance plan.

The Mount Sinai at Home service area is expanding as medical personnel become available. Please contact this program to see if Rehabilitation at Home is provided where you live, and whether your insurer includes these services as a covered benefit.