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Skilled Nursing Facility Care After a Hospital Stay

Long Term Care | August 31, 2018

Did you know?  If you’re covered by Medicare Part A, you may be eligible to receive skilled nursing care after a qualifying hospital stay.  Of course, as is often the case with Medicare, there are some limits to the duration of Skilled Nursing Facility (SNF) stays and the circumstances under which this care can be billed.  As one of the nation’s top providers of skilled nursing care, American Senior Communities would like to tell you a bit more about Medicare’s requirements for receiving care in a SNF after a hospital stay.  Read on to find out more!

Skilled Nursing Facility Care after a Hospital Stay

Medicare will fully cover up to 20 days of SNF care per hospital stay, and could partially cover an additional 80 days, provided your hospital stay meets the following conditions:

  • You must enter an approved SNF within 30 days of your qualifying hospital stay
  • Your hospital stay must have lasted at least 3 days (any time spent in the hospital as an outpatient or while under observation does not count towards this total).
  • Your physician must decide and recommend that daily SNF care is necessary to treat your condition.

Treatment must be provided daily by an RN, a licensed physical therapist, or a licensed practical nurse.

These are only the most basic requirements to receive Medicare coverage for your SNF stay. There may be other conditions that must be met, so be sure to talk to your doctor and check in with medicare.gov for the full list of requirements and other conditions.The Cost of Skilled Nursing Facility Care under Medicare

When you receive SNF care after a qualifying hospital stay, your first 20 days are covered 100%.  Days 21-100 will require a coinsurance payment of $167.50 per day which a supplemental insurance should cover.  Once you reach day 101, you will be responsible for all additional costs. In addition, if you stop receiving daily care during that time, or if you leave the facility for more than 30 days, you will need a new 3-day inpatient hospital stay to continue having your SNF care covered by Medicare.  It’s also important to remember that your doctor or SNF provider may recommend services that are not covered by Medicare. In these cases, you may be responsible for paying part or all of those costs, so be sure to ask plenty of questions about whether such services are absolutely necessary and whether Medicare will cover them.

SNF care isn’t just for seniors; spending time in a SNF can be an excellent way to recover after a hospital stay so you can ensure you get the daily attention you need to get back to your everyday life.  If you’re on Medicare and are currently in the hospital or have received hospital care in the previous 30 days, you could be eligible to stay in a SNF for little or no cost. Taking advantage of this program may be just what you need to get back on your feet, so don’t be afraid to ask lots of questions to find out if your hospital stay qualifies. Not sure where to start? Contact American Senior Communities and we can point you in the right direction!

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