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Sadie Mays

The First 72 Hours in Skilled Nursing Rehab: A Family Guide to the Critical Initial Period

Originally published: January 2026 | Reviewed by Sadie Mays

The First 72 Hours in Skilled Nursing Rehab: A Family Guide to the Critical Initial Period

Moving a loved one from the hospital to a skilled nursing facility for rehab can feel rushed and confusing. 

You might have dozens of questions about what happens next, who will be caring for them, and whether they’re getting the proper treatment.

A calm, practical paragraph: the first 72 hours are about stabilizing the transition, completing assessments, starting therapy, aligning on goals, and preventing avoidable setbacks. 

The first 72 hours in skilled nursing rehab focus on safety checks, therapy evaluations, and building a personalized care plan that sets the direction for the entire stay.

During this window, staff assess your loved one’s medical needs, physical abilities, and goals. They also begin coordinating with insurance and planning for discharge, even if that seems somewhat premature.

Knowing what to expect during the initial transition to a skilled nursing facility helps families ask the right questions. It allows you to identify potential problems before they become serious.

Key Takeaways

  • The first three days involve medical intake, therapy evaluations, and creating a care plan tailored to your loved one’s needs.
  • You’ll meet nurses, therapists, social workers, and case managers—each handles a specific part of recovery.
  • Families can best support rehab by asking questions, attending care meetings, and understanding what progress and warning signs look like.

Quick Answer — What Happens In The First 72 Hours

Quick Answer — What Happens In The First 72 Hours

The first 72 hours in skilled nursing rehab are all about getting your loved one settled, assessed, and started on their care plan. 

This period provides the SNF team with an opportunity to understand your family member’s needs and to begin their recovery journey.

Key activities during this time include:

  • Intake and admission paperwork – You’ll complete medical history forms and insurance documentation.
  • Medical assessment – Nurses check vital signs, review medications, and evaluate overall health status.
  • Physical and occupational therapy evaluations: therapists assess strength, mobility, and activities of daily living.
  • Care plan development – The team creates a personalized treatment schedule based on assessment results.
  • Room orientation: Staff should show your loved one around their room and explain the call buttons, bathroom features, and safety equipment.

Your family member will meet their care team during these first days. This includes their assigned nurse, therapy staff, and the attending physician who oversees their senior care.

The skilled nursing facility sets a baseline for tracking progress. They assess factors such as walking distance, need for assistance with eating or bathing, and pain levels.

Nursing staff check in often to watch for complications or adjustment issues. Many nursing homes encourage family visits during this time to help your loved one feel more at ease.

The team also discusses discharge goals with you and provides an estimated timeline for rehab.

 Sadie G. Mays Health & Rehabilitation Center can explain what to expect in the first 72 hours and how to support rehab safely. Schedule a tour.

If you’re ready to get started, call us now!

Before Arrival — What To Confirm With The Hospital And Admissions

Before Arrival — What To Confirm With The Hospital And Admissions

Before your family member leaves the hospital, you need to confirm some medical and logistical details. Just two phone calls can prevent delays and make sure the facility is ready for admission.

Two Calls To Make Before Transport

Call the hospital discharge planner first. Confirm which documents will travel with your family member—you should get a discharge summary, medication list, and any physician orders for continued care.

Ask if advance directives are in the transfer packet or if you need to bring your own copies. The discharge planner should also inform you of the arrival time and the location to report on admission day.

Write down the contact name and direct phone number in case transport problems come up. Your second call goes to the skilled nursing facility’s admissions department.

Confirm that they have received authorization from the insurance company and that a bed is available. Request any additional paperwork you need, such as insurance cards, photo ID, or legal documents.

Obtain the admissions coordinator’s direct number so you can reach them if transport is delayed or something unexpected happens.

Hours 0–24 — Intake, Safety Checks, And “Getting Oriented”

The first day at a skilled nursing facility is all about safety and information gathering. When your family member arrives, the nursing staff does an admission assessment that covers medical history, medications, and care needs.

What happens during intake:

  • Review of all current medications and prescriptions
  • Documentation of allergies and medical conditions
  • Fall risk assessment
  • Skin integrity check
  • Vital signs monitoring

The care team sets up the needed medical equipment in the room. This could be a wheelchair, walker, oxygen, or special bed rails.

Staff show your loved one how to use the call button and explain safety features. Medication management begins immediately, and the facility pharmacist reviews all meds for interactions or duplications.

Your family member might not get their medications at the same time as they do at home. Facilities keep to their own schedules, which can feel odd at first.

During the first 24 hours, getting oriented to the new surroundings can be challenging. Nursing staff help your loved one find the bathroom, understand meal times, and learn the daily routine.

Confusion or anxiety is widespread during this adjustment. Nurses check in often to see how your loved one is settling in and watch for any immediate concerns.

The care team documents everything to build a full picture of your loved one’s baseline condition.

Hours 24–48 — Therapy Evaluations And The First Rehab Plan

On the second day, your family member meets with therapy specialists who assess their rehabilitation needs. Physical therapists, occupational therapists, and speech therapists assess strength, mobility, and activities of daily living.

Each therapist runs their own evaluation, usually lasting 30 to 60 minutes. They test walking ability, balance, arm and leg movement, and self-care tasks such as dressing and eating.

What Therapists Assess:

  • Current physical abilities and limitations
  • Cognitive function and memory
  • Safety awareness and fall risk
  • Ability to perform basic daily activities
  • Communication and swallowing skills (if needed)

The therapy team uses these evaluations to create a personalized care plan for your loved one. This plan specifies when therapy sessions will take place, how often, and the goals the team aims to achieve.

Within 48 hours, skilled nursing facilities must complete a baseline care plan that includes rehab services and treatment approaches. 

The plan shows which therapies your family member needs and how many sessions per week they’ll get.

You should get information about the therapy schedule at this point. Most patients attend several therapy sessions each week, depending on their condition and goals.

The care team explains the anticipated therapy interventions by discipline. They’ll talk about how intense and frequent the sessions will be, so you know what to expect going forward.

Hours 48–72 — Care Planning, Insurance/Payer Clarity, And Discharge Direction

During this stretch, the facility completes a baseline care plan within 48 hours of admission. This document outlines the specific care instructions your family member requires.

The care team holds a conference to review this plan with you. Expect discussions about medical needs, nutrition, rehab, and safety during the meeting.

Key topics covered include:

  • Medications and treatments
  • Therapy schedules and goals
  • Dietary needs and restrictions
  • Equipment requirements
  • Safety precautions

The billing team checks Medicare or other insurance benefits and explains what services are covered. They’ll also discuss how long coverage may last, depending on your loved one’s condition.

The staff starts mapping out a discharge plan. Even if it feels early, this helps set realistic goals and prepares everyone for the next steps.

You’ll hear about possible discharge destinations—maybe home, another facility, or extended care. Follow-up appointments with physicians may be scheduled, and the team will identify any home services or equipment your family member may need upon discharge.

Ask questions about the care plan. If something doesn’t make sense or doesn’t match what you expected, speak up—this is your chance to clarify the path forward and understand the recovery timeline.

 If you’re coordinating a hospital-to-rehab transfer, Sadie G. Mays Health & Rehabilitation Center can walk you through therapy timing, care plans, and paperwork. Contact us.

If you’re ready to get started, call us now!

Who You’ll Meet (And What Each Role Handles)

Your loved one will meet a bunch of staff members during the first 72 hours, each taking care of a different piece of recovery. Knowing who does what makes it easier to get answers when you need them.

Clinical Team: Nurse, Therapy, Physician/NP (What They Handle)

Registered Nurses (RNs) provide round-the-clock care and manage medication. They monitor vital signs, assist with activities of daily living (ADLs) such as bathing and dressing, and respond to medical needs. You’ll most often see nurses, since they work shifts all day and night.

Physical Therapists (PTs) focus on mobility, strength, and balance. They help your loved one walk, transfer from bed to chair, and avoid falls.

Occupational Therapists (OTs) help with daily living skills—eating, dressing, bathing—so your loved one can stay independent.

The Attending Physician or Nurse Practitioner oversees the medical treatment plan. They usually visit a few times per week, not every day, but they review test results, adjust medications, and coordinate with your primary care physician.

Speech-Language Pathologists check swallowing safety and communication skills as needed. They figure out which foods and drinks are safe for your loved one.

Support Team: Social Services/Case Management, Admissions/Billing (What They Handle)

Social Workers address emotional adjustment and family concerns. They handle discharge planning, connect you with community resources, and help if your loved one seems anxious or depressed during the transition.

Social workers also coordinate home equipment. If going home isn’t possible, they discuss long-term care options with you.

Case Managers track insurance authorizations and plan discharge timelines. They coordinate with insurance companies regarding approved days and schedule follow-up appointments with physicians.

Admissions and Billing Staff handle insurance verification, co-pays, and financial questions. They explain what insurance covers and what you’ll need to pay out-of-pocket.

These staff members work at the rehabilitation facility to ensure the administrative process runs smoothly from admission to discharge.

What’s “Normal” Vs Red Flags In The First 72 Hours

Your loved one will go through a lot of changes during their first days in skilled nursing rehab. Some are entirely expected, while others require prompt attention.

Normal Changes to Expect:

  • Tiredness and more sleep as the body heals
  • Mild confusion or feeling lost in a new place
  • Less appetite or eating less than usual
  • Minor mood swings or frustration with new limits
  • Some discomfort during therapy

Red Flags That Need Immediate Attention:

  • Sudden confusion or big personality changes
  • Fever over 100.4°F or signs of infection
  • Difficulty breathing or chest pain
  • Extreme drowsiness or can’t wake up
  • Severe pain that meds don’t help
  • Refusing care or therapy for a long time
  • Falls or almost falling
  • Swelling, redness, or warmth in the legs
  • Changes in vital signs outside normal ranges

If something feels off, speak up. Trust your gut about your family member’s condition.

Staff should listen and assess any symptoms that concern you.

What to Do When You Spot a Problem:

  1. Tell the nurse right away
  2. Ask what they’ll do to fix it
  3. Request that they document your concern
  4. Check back in a few hours

The first 48 hours after surgery can be risky for complications. Stay alert—your observations really do help the care team catch problems early.

How Families Can Support Rehab Progress (Without Getting In The Way)

Your presence matters during the first 72 hours, but knowing when to step back is equally important. Family involvement can make a big difference when you find the right balance.

What helps:

  • Ask therapists what you can practice at home
  • Take notes during care team meetings
  • Bring items from home that comfort your loved one
  • Encourage your loved one during tough exercises
  • Celebrate small wins, even if it’s just a few extra steps

What doesn’t help:

  • Doing things your loved one should do themselves
  • Questioning treatments in front of the patient
  • Staying for every therapy session without being asked
  • Bringing foods that break dietary rules
  • Overriding staff decisions about meds or care

The therapy team needs space to see what your loved one can really do. If you jump in too soon, therapists can’t get a clear picture.

Communication with the care team is most effective when you share what you notice rather than making demands. If you notice pain, confusion, or a change in mood, inform staff.

Try to save your questions for family meetings or scheduled check-ins. Interrupting therapy can actually slow progress and wear your loved one out.

Your role is to provide emotional support while the professionals handle the medical side. That balance really helps your loved one build the independence they’ll need when it’s time to come home.

Atlanta Notes — Making The Hospital-To-Rehab Transition Smoother

If your loved one is transitioning to post-hospital rehabilitation in Atlanta, consult the hospital discharge team at least 24 hours before the move. They’ll help set up transportation and send medical records to the next facility.

Key documents to request before leaving the hospital:

  • Current medication list with dosages
  • Discharge summary with diagnosis codes
  • Therapy orders from the physician
  • Insurance authorization paperwork

Atlanta facilities usually admit new patients between 10 AM and 3 PM on weekdays. Some will accept weekend admissions, but there may be fewer staff available for the initial assessments.

What to bring on admission day:

  • Valid photo ID and insurance cards
  • Two weeks of comfortable clothing
  • Personal toiletries and medications
  • List of emergency contacts with phone numbers

The hospital team handles transportation arrangements with the rehab facility. You can go with private transport or use medical transport covered by Medicare—whichever works best for you.

Call the admitting facility on the morning of transfer to make sure the room’s ready. Atlanta traffic can be a pain, so leave early to avoid rushing during peak hours.

Most Atlanta rehab centers allow the family to stay during admission. The process takes about 2 to 4 hours, including the medical assessment, room orientation, and first care planning.

Bring your list of questions about therapy schedules or visiting hours. It’s a good time to get answers and settle in a bit.

For families planning skilled nursing rehab in Atlanta, get clear guidance and next-step support from Sadie G. Mays Health & Rehabilitation Center. Schedule an appointment.

Contact Us Today For An Appointment

    Frequently Asked Questions 

    What happens on the first day in skilled nursing rehab?

    On Day 1, staff confirm your loved one’s baseline needs, review hospital discharge information, check vital signs, address pain and safety, and help them settle in. Families can share routines and bring essential devices and paperwork.

    When does physical therapy start in a skilled nursing facility?

    Therapy often begins within the first 24–48 hours, depending on medical stability and physician orders. A therapist evaluates strength, balance, and mobility, then sets initial goals and a schedule that the care team monitors.

    What assessments are done in the first 72 hours of skilled nursing rehab?

    The team typically completes nursing and safety assessments, medication reconciliation, therapy evaluations (PT/OT and sometimes speech therapy), and discharge-planning discussions. These steps establish rehab goals, identify risks, and clarify the support needed for progress.

    Will a doctor or nurse practitioner see my loved one in the first few days?

    Many facilities arrange a physician or nurse practitioner evaluation early in the stay, but timing varies by facility and clinical needs. Ask admissions who provides medical coverage and how families can request updates during the first 72 hours.

    How is the rehab plan decided during the first 72 hours?

    The rehab plan is built from therapy evaluations, nursing observations, and the resident’s medical status and goals. Families can add crucial context by describing pre-hospital abilities, home setup, and discharge priorities.

    What should families bring or do during the first 72 hours?

    Bring a medication list, insurance cards, key devices (glasses/hearing aids/dentures), comfortable therapy clothes, and non-slip shoes. Call admissions to confirm rules, attend early care discussions, and share baseline function and safety concerns.

    What are red flags to watch for after a hospital-to-SNF transfer?

    Call staff immediately for new or worsening confusion, breathing trouble, uncontrolled pain, sudden weakness, fever, falls, or missed medications. After hospitalization, small changes can quickly become serious; report concerns promptly.