Hospital and rehab discharge
They have given you a date, and she cannot go home
This is the most common way families reach us, and it is the worst possible moment to be learning how any of this works. So here is the order to do things in, written for somebody who has about four days.
Call (714) 975-9652 nowOpen every day until 6pm. If it is a discharge, say so when we pick up and we will move you to the front.
Today, before anything else
Four things to do in the next few hours
In this order. Each one changes what the others are worth.
- 1
Ask the case manager one specific question
Not "what are our options". Ask: "Is she inpatient, or is she under observation?" The answer decides whether Original Medicare will pay for rehab, and families routinely find out too late that the answer was observation. Write down the answer and the date she was admitted as an inpatient.
- 2
Ask what level of care she is being discharged at
Specifically: can she walk, can she transfer, does she need one person or two, is she continent, is she confused. This list is the thing every care home will ask you for, and having it in writing from the hospital saves a day of back and forth.
- 3
Ask for the discharge planning conversation in writing
Hospitals have discharge planning duties, and a written plan is both useful and a mild form of leverage. It also gives you the list of facilities the hospital will offer, which you should treat as a starting point rather than a shortlist.
- 4
Ask for the referral contact the hospital owes you
California law requires a hospital to give every patient expected to need long-term care at discharge the contact details of at least one public or nonprofit organisation providing information and referral for community-based long-term care in their county — at minimum the area agency on aging. Most families are never offered it. Ask for it by name.
- 5
Start the care home search in parallel, not afterwards
This is the mistake almost everyone makes. Families wait for rehab to be arranged and then start looking for somewhere permanent, which is how a three week rehab stay turns into a panicked weekend. Start both at once.
The rule that catches everybody
Observation is not admission
Under Original Medicare (Part A), a skilled nursing facility stay is covered only after a medically necessary inpatient hospital stay of at least three consecutive days, not counting the day of discharge. Admission to the nursing facility generally has to follow within 30 days.
Time spent in the emergency room, or in the hospital under observation status, does not count towards those three days — even if she slept there overnight, in a bed, on a ward. Families discover this when the bill arrives.
If your parent is on a Medicare Advantage plan rather than Original Medicare, the plan may waive the three day requirement, and most do. Check the plan's Evidence of Coverage, or ask the case manager to check it with you.
42 CFR 409.30 and Medicare.gov, checked 13 October 2026.
What Original Medicare pays for rehab in 2026
- Days 1 to 20
- No coinsurance
- Days 21 to 100
- $217 a day
- Day 101 onwards
- All of it
The 2026 coinsurance figure is $217.00 per day, set by CMS in the Federal Register on 19 November 2025 and effective 1 January 2026. CMS has not yet announced the 2027 amount.
Most people never reach day 100. Coverage stops when she no longer needs skilled care, which is frequently at two or three weeks — and that is the day the family needs somewhere for her to go. Medicare Advantage plans set their own cost sharing.
Anaheim's hospitals
Where this usually starts
Five general acute care hospitals are licensed and open in the city. If you are reading this from a waiting room, it is probably one of these.
AHMC Anaheim Regional Medical Center
1111 W La Palma Ave, Anaheim
Kaiser Foundation Hospital – Orange County – Anaheim
3440 E La Palma Ave, Anaheim
West Anaheim Medical Center
3033 W Orange Ave, Anaheim
Anaheim Global Medical Center
1025 S Anaheim Blvd, Anaheim
Anaheim Community Hospital, LLC
3350 W Ball Rd, Anaheim
From the California Department of Public Health licensing listing dated 1 October 2026, all five showing facility status Open. Emergency department availability varies and state and federal records do not fully agree on it, so check directly before travelling to one for emergency care.
What we do in a discharge
Same day, usually within the hour
You tell us what the hospital said she needs. We tell you, from the 97 licensed homes in Anaheim, which ones have a bed this week, which can legally take her level of need, and which we would rule out.
Then we go and look. Discharges do not wait for a convenient appointment, so neither do we — if the date is Friday we will be at a home with you on Wednesday.
And if the honest answer is that she needs skilled nursing rather than a care home, we will tell you that too, even though it earns us nothing. Placing somebody into a home that cannot legally care for them is a misdemeanor in California, and it is also just a terrible thing to do to a family.
Common questions
Discharge, answered plainly
- How long does Medicare pay for rehab after a hospital stay?
- Under Original Medicare Part A, a skilled nursing facility stay is covered for up to 100 days in a benefit period: days 1 to 20 with no daily coinsurance, and days 21 to 100 with a daily coinsurance, which is $217 per day in 2026. Most people do not reach day 100 — coverage ends when skilled care is no longer needed, which is often much sooner.
- Why does the hospital say my mother's stay does not count toward Medicare rehab?
- Because of the three day rule. Under Original Medicare, a skilled nursing facility stay is covered only after a medically necessary inpatient hospital stay of at least three consecutive days, not counting the day of discharge. Time in the emergency room or under observation status does not count, even overnight. Medicare Advantage plans may waive this requirement and most do, so if your parent is on an Advantage plan, check the plan's Evidence of Coverage.
- Can the hospital discharge my parent if we have nowhere for them to go?
- The hospital cannot simply put somebody on the pavement, but it is also not obliged to keep a patient who no longer needs hospital care while a family looks for a home. This is why the search needs to start the day you are told a discharge is coming, not the day it happens.
- What is the difference between a rehab facility and a care home?
- A skilled nursing facility is licensed by the Department of Public Health and has nurses on duty around the clock; it is where short-term rehab after a hospital stay usually happens. A residential care home is licensed by the Department of Social Services for non-medical care, and it is where somebody lives afterwards if they cannot go home. They are different licences and different buildings, and families are often told about the first while needing to arrange the second.
If there is a date, call rather than fill this in
The form is here because some people would rather type than talk. But if you have been given a discharge date this week, the phone is faster and we will stay on it with you.
Tell us who you are looking after
Four short questions. Nothing you answer is shared with a facility until you say so.
Prefer to talk now? (714) 975-9652, open every day until 6pm.