Rehab, skilled nursing, assisted living, memory care: who's who

The first time a hospital told us a parent was "going to rehab," I pictured a gym. Then someone said "skilled nursing." Then "assisted living." I thought they were the same thing. They're not, and the difference matters a lot for who pays.

Here's the cheat sheet.

Inpatient rehab

• Intense therapy, usually several hours a day, after a stroke, surgery, or serious injury.
• Short stay. The goal is to get home.

Skilled nursing facility (often called "rehab" too)

• Daily nursing care or therapy after a hospital stay, at a slower pace.
• Short term. Medicare can help pay for up to 100 days, with a daily copay after the first 20.
• To qualify under Original Medicare, your parent usually needs a hospital stay of at least three days as an admitted patient.

Assisted living

• An apartment-style home with help for daily tasks like bathing, dressing, and medications.
• Long term. This is where someone lives.
• Medicare does not pay for it. Most families pay privately, sometimes with long-term care insurance.

Memory care

• Assisted living built for people with dementia or memory loss, with more supervision and security.
• Also long term, and also usually private pay.

Nursing home (long-term care)

• 24-hour care for people who need help with most daily needs.
• Medicare does not pay for long-term stays. Families pay privately, or Medicaid may pay once savings run low.

The part nobody told me

Ask the hospital one question: "Is my parent admitted, or here under observation?" Observation days don't count toward the three-day stay. A parent can sleep in a hospital bed for three nights and still not qualify for Medicare to cover skilled nursing. Medicare Advantage plans have their own rules, so call the plan too.

Your best ally in the hospital is the discharge planner or social worker. Ask for them by name. They know the local options and what your parent's insurance covers.

Let's figure this out together.

I'm not a lawyer or financial advisor. This is what I've learned as a daughter going through it. Check the details for your own plan and state.