Skilled Nursing Facility Medicare Part A Benefit Quick Reference

In order to qualify for Medicare Benefits:

  • Beneficiary must have Medicare Part A with days left in their 100 day benefit period
  • A medically necessary inpatient hospital stay of at least 3 consecutive days
  • Transferred to a Medicare participating skilled nursing facility (SNF) within 30 days of hospital discharge
  • Care in the SNF must relate back to what the beneficiary was treated for in the hospital or a new condition arising while in the qualifying stay or SNF
  • Required care must be of a level of complexity or the patient’s condition such that it can only be provided by or under the supervision of the licensed nurse or therapist
  • Services should be of a level that can only practically be provided on an inpatient basis.

Keep in mind:

  • 100 days are not guaranteed.  Residents must continue to show tangible improvement towards attainable goals in order to remain on Medicare A.  Frequent progress reports are available from Therapy or Nursing.
  • Residents must be 60 days clear of previous Medicare A stay without hospitalizations to be eligible for used Medicare days to reset back to 100.