Medicare Skilled Nursing Facility (SNF) Guidelines & Coverage

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.