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Skilled Nursing Facility Medicare Part A Benefit Quick Reference Fact Sheet

Beneficiary must have Medicare Part A with days left in their 100 day benefit period.

A medically necessary inpatient hospital stay of at least three consecutive days (date of discharge is not included, observation and emergency room time does not count towards the qualifying stay).

Transferred to a Medicare participating SNF within 30 days of hospital discharge for exception refer to the CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 8, Section 20.2.2.

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.

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