Centers for Medicare and Medicaid Services (CMS)
All acute rehabilitation hospitals must follow admission criteria as determined by the Centers for Medicare and Medicaid Services. According to CMS rules, patients will benefit from acute rehabilitation if they meet the following admission criteria:
- Patient must be able to participate in and benefit from intensive rehabilitation three hours a day, five days a week
- Patient requires two or more therapies: Physical Therapy, Occupational Therapy, Speech Therapy
- Patient requires 24-hour medical/nursing care with daily oversight from a Physiatrist
- Patient requires capacity for functional improvement based on goals determined by clinical team
MEDICARE PART A BENEFITS (Hospital Insurance Costs)
Medicare Part A Benefits for Hospital Stays
- Medicare pays 100% for the first 60 hospital days
- 30 co-insurance days and 60 lifetime reserve days
- Patient is required to pay a deductible for each episode:
- Days 1 – 60: $1,216 deductible
- Days 61 – 90: $304 per day co-payment
- Days 91 and beyond: $608 per day co-payment
- Episode ends after 60 days of being at home without an inpatient admission
Part A and Skilled Nursing Facilities
- Three midnight stay in acute care hospital to qualify
- Patient must have a skilled need and physician order
- Medicare covers 100% of first 20 days
- Patient has co-payment of $152 for days 21-100
- Eligible benefit is 100 days - but patient doesn't need to be there for 100 days
Part A and Home Health
- Medicare Part A pays 100%
- Patient must qualify as "home bound"
- Agency providing the service must be Medicare-certified
- Benefit requires physician prescription and physician involvement
- Pays 20% of Medicare allowance amount for durable medical equipment
Medicare Part B Benefits
- Covers eligible physician services, outpatient therapy/hospital services, and durable medical equipment
- Annual cap of $1,920 for physical therapy and speech therapy combined; $1,920 for occupational therapy
- $104.90 in premiums each month
- $147 deductible
- 20% co-pay
- Premium adjusts based on income
For more information on Marianjoy Rehabilitation Hospital acute rehabilitative care, call the Marianjoy Admissions Department at 630-909-8920. A Marianjoy Admissions representative will be available to explain the admissions process and help you schedule a tour.
Marianjoy Rehabilitation Hospital is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) and the Joint Commission
Supportive Resources for Admission
This self-referral will authorize a Marianjoy Nurse Liaison and/or Physician to visit you and determine the appropriate level of rehabilitation for your needs.
Keep one form with you and give the other form to your acute hospital case manager.
Click below for a complete listing of locations where Marianjoy physicians and associates provide services.