Medicare covers skilled nursing facility (SNF) care in certain circumstances, but some situations can impact what is covered or even or if SNF care will be covered and your costs for that care.
If you are in the hospital, your doctor can order observation services to decide if you should be admitted to the hospital or be discharged. During the time you’re considered an outpatient and that time does not count towards the 3-day inpatient hospital stay required Medicare to cover a SNF stay after you are released. For this reason, it is essential to ask if you are being admitted as an inpatient or in observation. Recent legislation requires the hospital to inform you, but this can often be lost in the overwhelming amount of information provided to you.
Meeting the 3-day inpatient hospital stay requirement
Below are a couple of examples showing if you have met the 3-day inpatient hospital stay requirement:
Situation 1: You ER and were formally admitted to the hospital as an inpatient for 3 days and were discharged on the 4th day. In this case, you met the 3-day inpatient hospital stay requirement for a covered SNF stay.
Situation 2: You went to the ER and spent one-day receiving observation services. You were then admitted to the hospital as an inpatient for two more days. After being released, a SNF stay would not be covered since you spent one day in observation, which does not count toward the 3 days of inpatient care required for SNF care to be covered, and you then only spent two days as an inpatient before being released.