What Does Medicare Pay for at a Skilled Nursing Facility?
Have you ever wondered what Medicare pays for at a Skilled Nursing Facility (SNF)? SNFs receive per-diem payments from Medicare Part A. Per-diem payments (i.e., a set amount for each day) are issued based on the number of days the resident receives treatment from a healthcare provider following a 3-day qualifying hospital stay. These payments are negotiated rates that act as an allowance to include the cost of services for any given day. Following a 3-day qualifying hospital stay, Medicare Part A fully covers up to 20 days per benefit period. The per diem pays for room and board, nursing and related services, therapeutic services, medications, and supplies.
Each benefit period begins on the day a resident enters a SNF and ends when the resident has been out of the facility for 60 consecutive days. After 20 days, the individual’s co-insurance (if available) pays for up to an additional 80 days of care. All benefits are exhausted once a resident has been in an SNF for 100 days. Then, at this time, the beneficiary begins paying for all services that are not covered under Medicare Part B. For more information on CMS programs, policies, and initiatives, please be sure to check out The Medicare Learning Network.