Medicare’s Skilled Nursing Facility (SNF) Three-Day Inpatient Stay Requirement: In Brief

Summary

Medicare beneficiaries are generally entitled to coverage for care they receive in a skilled nursing facility (SNF). However, Medicare beneficiaries can be liable for substantial cost sharing related to the care they receive in an SNF if that care is not preceded by a hospital inpatient stay of at least three days. On an increasing basis, however, Medicare beneficiaries are failing to meet this three-day inpatient stay requirement because they are receiving shorter inpatient hospital stays and overnight observation care as hospital outpatients, often for days at a time, which does not qualify for Medicare Part A-covered SNF care.

key terms: Medicare, SNF, hospital, outpatient observation, three day, three day inpatient, skilled nursing facility, post-acute care, 3-day inpatient stay requirement, Medicare Part A, Medicare Catastrophic Coverage Act (MCCA; P.L. 100-360), NOTICE Act (P.L. 114-42).