Rehab Facility Neglect: When a Short-Term Rehab Stay Causes Harm

• Skilled nursing facilities (SNFs). The most common rehab setting after a hospital stay, often a wing of a nursing home. Under traditional Medicare, SNF coverage generally requires a prior inpatient hospital stay of at least three consecutive days, not counting the discharge day (42 CFR 409.30).
• Inpatient rehabilitation facilities (IRFs). Rehab hospitals or hospital units for patients who can handle intensive therapy. Medicare’s rules describe that therapy as generally at least 3 hours a day, at least 5 days a week, with a rehabilitation physician seeing the patient in person at least 3 days a week (42 CFR 412.622).
• Long-term acute care hospitals, for patients who need extended hospital-level care, such as ventilator weaning.

The type of facility matters, because different rules and deadlines apply.

Short-stay rehab patients are often at their most fragile: just out of surgery, weak, on new medications, and sometimes confused. Common harms include:

• Falls, especially getting up to the bathroom without help. See our nursing home falls page.
• Bed sores that start within days on the heels, hips or tailbone. See our bed sores page.
• Infections: surgical wound infections, urinary infections from catheters, pneumonia and sepsis.
• Medication errors: missed doses of blood thinners, pain medicine or insulin, wrong drugs, or dangerous combinations.
• Missed or skipped therapy that leaves the patient weaker than when they arrived.
• Dehydration and poor nutrition.
• Failure to recognize a change in condition, like a blood clot, a stroke or a worsening infection, and get the patient back to the hospital in time.
• Unsafe discharge home before the patient or family is ready.

Skilled nursing facilities that take Medicare or Medicaid must meet federal requirements, including:

• A baseline care plan within 48 hours of admission, covering physician orders, diet and therapy (42 CFR 483.21(a)).
• Accident prevention: an environment “as free of accident hazards as is possible” and “adequate supervision and assistance devices to prevent accidents” (42 CFR 483.25(d)).
• Pressure ulcer prevention and treatment (42 CFR 483.25(b)).
• Freedom from significant medication errors (42 CFR 483.45(f)).
• Prompt notice to the doctor and the family when the patient’s condition significantly changes (42 CFR 483.10(g)).
• Discharge planning aimed at reducing preventable readmissions (42 CFR 483.21(c)).
• No forced arbitration. A facility can’t require an arbitration agreement as a condition of admission or of continuing care (42 CFR 483.70(m)).

Kentucky’s residents’ rights statute also applies to long-term-care facilities, which include nursing facilities and nursing homes, and lets a resident sue when those rights are violated (KRS 216.515). Inpatient rehab hospitals follow hospital standards, and claims against them are usually treated as hospital malpractice claims.

• Your loved one is weaker, more confused or sleeping more than when they arrived
• Therapy sessions are canceled, short or not happening
• Call lights go unanswered and your family member is left in a soiled bed or chair
• New bruises, skin tears or redness on the heels, hips or tailbone
• Fever, a wound that looks worse, or a strong urine odor
• Staff can’t tell you what medications they’re giving
• A sudden transfer back to the hospital

If you see these signs, ask for a care plan meeting, write down names and dates, and put concerns in writing. See what to do if you suspect nursing home neglect.

• The admission assessment and baseline care plan
• Physician orders and the medication administration record
• Therapy logs showing the minutes of therapy actually provided
• Nursing notes, skin assessments and fall risk assessments
• Incident reports (the facility may resist producing these)
• Hospital transfer and readmission records
• Discharge planning notes

See how to request medical records.

• Injury claims against a skilled nursing facility generally have one year. Claims based only on rights created by Kentucky’s residents’ rights statute can have five years but end if the resident dies, while injury claims survive (Overstreet v. Kindred Nursing Centers, Ky. 2015).
• Claims against an inpatient rehab hospital are usually hospital malpractice claims with a one-year deadline from discovery (KRS 413.140).
• A certificate of merit must be filed with a malpractice complaint or a claim that a long-term-care facility failed to provide proper care (KRS 411.167).
• If the patient died, the estate’s personal representative brings the claim. See our wrongful death page.

See our statute of limitations guide. Because rehab stays are short, records can be archived quickly. Act soon.

We get the full record, including therapy minutes, medication records and the hospital readmission chart, and have it reviewed by qualified nurses and physicians to show what the facility should have done. We also check the admission paperwork for arbitration clauses. We prepare every case for trial. Larry Forman has tried 50+ jury trials and won 95% of them. See our case results (past results don’t guarantee a similar outcome) and our main nursing home abuse lawyer page. Hip fractures after a fall are covered on our broken bone injury page.