Preparing for Rehabilitation

Preparing For Rehabilitation Following Cardiac Surgery: A Patient's Guide

There are several possible discharge plans following your cardiac surgery. The purpose of this guide is to help you understand what those options are and how best to prepare for them.

The need for cardiac rehabilitation will depend on three things:

  • Your medical condition (determined by the health care team)
  • Your functional ability (how well you can move about and participate in the activities for rehabilitation)
  • Your insurance

Following your heart surgery you may have one, or a combination, of the following options :

  • Discharge home with home care
    These services are provided in the home and generally last 30- 60 minutes, two or three times a week.
  • Discharge home with outpatient cardiac rehabilitation
    These services are provided at a qualified outpatient facility. Treatment is two to three times per week, usually for 60 minutes (one hour) per session. These sessions will include a heart monitor during your exercise therapy. Rusk at 34th Street has a multidisciplinary, comprehensive Outpatient Cardiac Rehabilitation Program
  • Discharge from the hospital to an inpatient acute cardiac rehabilitation program
    These services are provided in a hospital and offer intensive therapies at least three hours per day including daily 90 minutes of heart monitored exercise therapy. Inpatient acute cardiac rehabilitation typically involves a hospital stay of a week or more, and is accompanied by thorough discharge planning. The Rusk Institute at 34th Street has a multidisciplinary, comprehensive Cardiac Rehabilitation Program.
  • Discharge from the hospital to an inpatient subacute rehabilitation program
    These services—provided in a Skilled Nursing Facility (usually on a distinct unit) with monitored exercise therapy—provide less intensive rehabilitation (less than three hours per day), generally over a period of several weeks or months.

Understand your insurance benefits/coverage:

  • If you have Medicare call 1-800- MEDICARE (1-800-633-4227) for information about your rehabilitation benefits.
  • If you have private insurance or managed Medicare/managed Medicaid contact your insurance company and ask about the rehabilitation services you are entitled to. Some helpful questions to ask include:
    • What are my rehabilitation benefits for acute/subacute/outpatient rehabilitation?
    • Do I need insurance authorization for acute/subacute or outpatient rehabilitation?
    • Is inpatient acute or subacute rehabilitation commonly authorized following my surgical procedure (e.g. coronary artery bypass surgery, valve repair or replacement)?
    • Do I need a physician's referral for outpatient or home care?
    • Are there limits on the number of inpatient acute or subacute days, outpatient or home care visits that I am entitled to?
    • Are there co-pays involved for care provided by facilities/individual providers? If so, are the co-pays different for in-network versus out-of-network facilities and providers?
    • Are there specific in-network facilities which I must choose?
    • Is the facility I'm interested in considered in-network? Are transportation costs between the hospital and the inpatient acute/subacute rehabilitation facility covered? (The Social Worker will make these arrangements for you.)
    • Does this involve an ambulette (which takes patients by wheelchair) or ambulance (which takes patients on a stretcher)?

Other pointers to prepare for rehabilitation:

  • Before your surgery, call rehabilitation facilities you are interested in if you have questions or would like to take a tour.
  • When you come to the hospital for surgery, bring several changes of comfortable clothing, sneakers or closed shoes for rehabilitation, or arrange for someone to bring them to you in the hospital.
  • Tell your social worker of your rehabilitation preferences (prepare a list of three acute and five subacute inpatient rehabilitation facilities).
  • Share the information that you have learned about your coverage with your Social Worker so s/he can verify and follow through on your plan.