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medicare adjustment

In the current world of uncertainty, the words of Helen Keller ring true, “Alone we can do so little, together we can do so much”.

With every day being so unpredictable, it is nice to see that the Centers for Medicare & Medicaid Services (CMS) has been working to try and make this chaos more manageable for both the patients and the skilled nursing facilities.

Medicare Major Adjustments

Recently, CMS released a statement making major adjustments to the Medicare requirements as they pertain to skilled nursing facilities.

Traditionally, a patient would require a 3-day hospital admission before entering a skilled nursing facility for Medicare to pay the rehabilitation fees for that client. As explained by the Medicare Rights Center:

At this time, Medicare has removed the 3-day qualifying hospital stay requirement for beneficiaries who experience dislocations or are otherwise affected by the coronavirus public health emergency. According to Medicare, this waiver includes but is not limited to beneficiaries who:

  • Need to be transferred to a SNF, for example, due to the nursing home evacuations or to make room for local hospitals
  • Need SNF care as a result of the current public health emergency, regardless of whether they were previously in the hospital

60-Day Requirement Period

In addition to the waiver of the 3-day admission, CMS has also adjusted the 60-day requirement in between benefit periods. As the Medicare Rights Center reports, “Beneficiaries who cannot start a new benefit period because of the public health emergency can get another 100 days or covered SNF care without having to begin a new benefit period.”

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