What is required before Medicare covers skilled nursing facility care?

Medicare requires a minimum of a 3-day inpatient hospital stay before it will cover skilled nursing facility (SNF) care. This requirement ensures that the beneficiary has received necessary acute care and stabilization before transitioning to a skilled nursing facility for rehabilitation or additional medical care. The intent is to confirm that the care needed is directly related to the hospital stay and that it is for conditions that are severe enough to require skilled nursing.

This rule is established to prevent unnecessary utilization of skilled nursing facility services and to ensure that Medicare resources are directed to beneficiaries who truly require that level of care following an inpatient hospitalization. If a patient is discharged from the hospital after a stay shorter than three days, Medicare will not provide coverage for services in a skilled nursing facility, making the three-day stay a critical element of eligibility for this benefit.

While a physician's note and enrollment in Part A are also important components of qualifying for certain Medicare benefits, they are not specific prerequisites solely for skilled nursing facility care. A referral from a specialist is typically not required for this type of coverage within Medicare.