Questions to Ask Rehab Admissions

You are on the phone, someone you love is in trouble, and the voice on the other end wants a decision. The admissions call is where a family either gets a plan or gets a pitch. SAMHSA publishes a short checklist for comparing programs: licensing and accreditation, evidence-based practices, a real role for family if the person in care wants one, help with the rest of life, and, for drug or alcohol problems, medicines that the FDA has actually approved. Use that list while you are still on the phone. Write the answers in the caller's own words. Facility rankings and a personal level of care belong with an assessment, not with a script.

If someone will not wake, is not breathing, or is having a seizure, call 911 before you call a program. For a mental health crisis, call or text 988.

Start with the checklist SAMHSA already published

SAMHSA says not every professional or program provides quality care in a healthy setting, and that you can ask a trusted person to help you compare options.

Licensed and accredited. The checklist says all programs and their health care professionals should be licensed and accredited. Ask for the current state license, the board you can use to verify it, and whether the program is accredited and by which organization. A scanned logo in an email is weaker than the state record. The choosing guide goes further on how to check a license. The list here is for the call itself.

Evidence-based practices. SAMHSA's examples include motivational interviewing or motivational enhancement therapy, cognitive behavioral therapy, cognitive processing therapy, education about the condition, supportive therapy, social skills training, and, for youth, behavioral management training. You do not need every name on that list. You do need the program to say which of them are on the schedule this week, who leads them, and how often. "We do groups" is not yet an answer.

Families. SAMHSA says family members can be included in treatment as desired by the person in care, and that families can help people understand the impact of a mental health or substance problem and can offer support. The desire belongs to the person in care, not to the relative who is paying. Ask whether family sessions exist, whether the patient can refuse them, and what you will be told if the patient says no. The family guide covers mutual-help groups for relatives and the situations where a joint session is a bad idea. The privacy guide explains when a program may even confirm that someone is there. Ask that question before you assume a callback means the chart is open.

The rest of life. SAMHSA says many programs help with other medical needs and with benefits such as housing, food assistance, job placement, supported employment, and longer-term recovery. Ask which of those are actually arranged, and which are a pamphlet. A residential stay that ends with no place to sleep is an incomplete plan. The aftercare guide covers the handoff to ask about before you travel.

Medicines, only where the FDA has approved them

SAMHSA tells families to ask about treatment using medications, and then draws a bright line. A professional or program should provide only FDA-approved medication for alcohol, tobacco, or opioid use. There are currently no FDA-approved medicines to help prevent a return to other substances such as methamphetamine and cocaine. Clinical trials are listed on ClinicalTrials.gov. A trial is not the same thing as an approved treatment you should expect on day one.

For opioid use disorder, NIDA names three FDA-approved medicines that help people stop or reduce opioid use: methadone, buprenorphine, and naltrexone. Ask whether the program continues a medicine a clinician has already started, which of the three it can provide, and who the prescriber is. The medication guide explains the differences without doses. A building that requires people to stop methadone or buprenorphine in order to be admitted is describing a rule you should hear before you book travel.

For cocaine or methamphetamine, ask which behavioral therapies are real on the unit. The cocaine guide and the methamphetamine guide name contingency management and cognitive behavioral therapy. If the caller says there is an FDA-approved medicine for cocaine addiction, that claim does not match NIDA or SAMHSA.

Level of care is an assessment, not a vacancy

ASAM says patients entering addiction treatment should receive a multidimensional assessment, that payers using the criteria should see that people get the least intensive but safe and effective care, and that patients should be reassessed as needs change. Ask what was assessed, which level is being offered, and why a lower or higher level was ruled out. Same-day outpatient care, an overnight stay, and a residential stay are different answers. The comparison guide and the inpatient versus outpatient guide explain those settings without assigning one to you.

Ask what the first days look like if withdrawal, pregnancy, or a psychiatric crisis is part of the history. The 72-hour guide covers evaluation and stabilization. The detox guide explains why alcohol and benzodiazepines are a poor fit for a nonmedical setting. An open bed is not a clinical recommendation.

Money, before anyone buys a ticket

Ask whether the plan requires authorization before admission, what the deductible and network status are, and what happens to the bill if the authorization is shortened after arrival. The prior authorization guide explains what that approval is. The cost guide covers deductibles and networks. If the answer is already a denial, the appeals guide covers the next step, not a louder sales call.

Bring the member ID, the date of birth, and the subscriber's information if the card is in someone else's name. "We will figure out the money when you land" is not a benefit check.

SmarterRecovery's how-it-works page says the referral service checks benefits before you commit. The check is not the insurer's final decision, and it is not a promise of a bed.

A short script

1. What is the state license number, and where do I verify it?
2. Which therapies on SAMHSA's list actually happen here?
3. Which FDA-approved medicines, if any, will be continued, and who prescribes them?
4. What level of care did the assessment support, and what happens in the first three days?
5. What can you tell me without the patient's consent?
6. Does this stay need prior authorization, and what do I owe if it stops?

You can compare names on FindTreatment.gov. A same-day appointment and a same-day bed are different questions. The same-day guide covers the federal clock, not a promise of an opening. Whether anyone can be admitted within seven days is a different limit. The same-week guide covers that limit. Call or text (800) 653-9376 if you want those questions asked against programs. There is no obligation to admit. If nothing fits, you should hear that plainly.

Additional Resources

Sources cited on this page:

• SAMHSA: Finding quality treatment
• ASAM: About The ASAM Criteria
• NIDA: Medications for Opioid Use Disorder
• NIDA: Cocaine research topic
• SAMHSA FindTreatment.gov
• 988 Suicide & Crisis Lifeline
• SmarterRecovery: How it works

Common Questions