After a hip fracture, the first weeks decide a lot. Learn how rehab placement, Medicare coverage, and San Diego resources fit together for your parent.
By Marcus Reyes, LSW · October 11, 2026
A broken hip is one of the most common reasons an older San Diego adult ends up in the hospital, and it often happens with little warning: a slip in the bathroom, a loose rug, a missed step. In my work with hospital case managers at Scripps, Sharp, and UC San Diego Health, I see the same pattern. Surgery usually happens within a day or two, and then the family is handed a short deadline to choose where recovery will take place. Discharge planning starts almost immediately, so it helps to start asking questions before the operation.
Ask the surgeon and the hospital case manager three things: when your parent will be allowed to bear weight, what level of therapy they are expected to need, and which discharge options the team recommends. Those answers shape everything that follows. If your parent also has dementia, tell the team right away, because confusion after surgery (delirium) is common and affects which setting is safest.
There are three main paths. A skilled nursing facility (SNF) offers daily nursing plus physical and occupational therapy and is the most common choice. An inpatient rehabilitation facility offers more intensive therapy, often about three hours a day, and suits patients who can tolerate that pace and are expected to make steady gains. Some patients go home with home health services, which works best when a capable family member or paid caregiver can be present and the home is set up safely.
Original Medicare may cover a SNF stay of up to 100 days per benefit period if your parent had a qualifying inpatient hospital stay of at least three days (observation status does not count) and needs daily skilled care. Days 1 through 20 are fully covered, and a daily coinsurance applies from day 21. Medicare Advantage plans have their own rules and often require prior authorization, so call the plan before accepting a bed. Free, unbiased Medicare counseling is available through HICAP at 800-434-0222. To compare facilities, review inspection and citation history on the California Department of Social Services site at ccld.dss.ca.gov for licensed residential communities, and use Medicare's Care Compare tool for nursing facilities.
Rehab is only part of the cost picture. Once Medicare skilled coverage ends, some families need custodial help at home or in assisted living for a few weeks or permanently. Medi-Cal may help with long-term care costs if your parent qualifies financially, and IHSS can pay for in-home caregivers for Medi-Cal recipients who need help with daily tasks. San Diego County's Aging & Independence Services, the local Area Agency on Aging, can point you to programs, caregiver support, and care coordination. Reach them through the Aging & Independence Services line at 800-339-4661.
If your parent is a veteran, ask about VA benefits early. VA San Diego Healthcare System in La Jolla (858-552-8585) can explain eligibility for home-based care and Aid and Attendance, which can help offset caregiving costs for qualifying veterans and surviving spouses.
Many hip fractures are followed by another fall within a year, so recovery planning should include prevention. Before discharge home, ask the therapist for a home safety evaluation. Typical fixes include grab bars, a raised toilet seat, a shower chair, removing throw rugs, better lighting, and a first-floor sleeping area if stairs are a problem. Review medications with a pharmacist, since sedatives and blood pressure drugs can add to fall risk, and ask the doctor about bone density testing and osteoporosis treatment.
If recovery stalls or your parent can no longer manage safely alone, a short respite stay or a move to assisted living may be the right next step. Tour in person, ask about staffing for mobility assistance and the community's discharge policies, and have your parent's therapist weigh in. A move made calmly, with information, almost always goes better than one made during a crisis.
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