Medicare SNF Guidelines

Skilled nursing facilities, or SNFs, are facilities certified by Medicare to provide rehabilitative services such as physical, speech, or occupational therapy, or to provide skilled nursing care. Medicare Part A will pay for short stays in an SNF to help you regain function after a hospitalization.

Three Midnight Rule

• In order to qualify for a Medicare-covered stay in a SNF, you must have spent at least three consecutive midnights as an overnight patient in a hospital. This hospitalization must have occurred within 30 days of your admission to the SNF.

Skilled Need

• Medicare will pay for your stay in a SNF if your doctor certifies that you have a skilled need, such as a need for physical therapy or IV antibiotics. The need for custodial care, or assistance with activities of daily living such as dressing, bathing or eating is not considered a skilled need and will not qualify you for Medicare reimbursement.

Length of Stay

• As long as the previous two criteria are met, Medicare will cover the total cost of your care in a SNF from day one through day 20. There is a co-pay for days 21 through 100. If you have supplemental insurance, it may cover the cost of the co-pay. The Medicare A SNF benefit expires after 100 days of skilled care.