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 subacute rehabilitation. Some patients may prefer to return home immediately, with the proper support and services in place.

The Rehabilitation at Home (RaH) program admits patients who are usually recommended for the program by inpatient physical therapists, social workers, or discharge planners. RaH is available to patients with appropriate insurance coverage and who live near Mount Sinai. 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 Recovery Care Coordinators, registered nurses, who will monitor health status, communicate with doctors, assist in making doctor appointments 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 to check vital signs and administer certain medications, including infusions
  • Rehabilitation services by physical therapists, occupational therapists, and speech therapists as ordered
  • Social work oversight to coordinate care and 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. We deliver all of these services for approximately 15 days with your RaH follow-up and for up to 60 days depending on the individual insurance plan.