If your parent has Medicare as their primary health insurance please review the 3 day rule to avoid high costs of short term rehab placement.
Today when someone goes to a hospital they usually begin their journey in the Emergency Room. Often they sit there for several hours and may be hooked up to an IV and receive diagnostic tests as well. All the while they are hoping to either be discharged home or be brought up to the inpatient floor.
Sometimes this process may take several days and what some don’t understand is that sometimes while in the ER they are in an observation bed not an admitted bed.
Your loved one may believe that they were admitted simply because they were there for 2 days receiving care. On the 3rd day due to not meeting criteria to be hospitalized or simply for lack of available beds they may be offered a skilled admission to a nursing home.
A patient that is admitted to a nursing home for Skilled Nursing Care needs to have a 3 day admitted stay in a hospital. If they don’t Medicare will not cover the costs and the patient is responsible for any costs for care while there.
Since Covid this rule has been waived and Nursing homes could care for the resident if they met Medicare rules for coverage excluding the 3 day rule. On May 11th the Medicare waiver will be discontinued and the 3 day rule will need to be followed again.
Please see the link below that explains the 3 day rule
Ensure prior to discharge that you ask your hospital discharge planner if your parent met the 3 day hospitalization rule “to avoid Improper payments that can occur when a hospital discharges an inpatient before they meet the 3-day rule and the SNF admits them for extended care services.” noted in link above.
We need to be advocates for our parents or loved ones when they are unable to advocate for themselves. Please reach out to me via the email below if you have any questions re: Medicare rules and if you need help in determining if your loved one meets Medicare coverage rules. I will be happy to help you.
The information presented is informative and does not constitute direct legal or regulatory advice
September 2024\Skilled Nursing Support\maria.messina@skillednursingsupport.com
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March 2023/ Skilled Nursing Support/ maria.messina@skillednursingsupport.com
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