A new cog in the federal response to the Coronavirus outbreak are some changes in how individuals on traditional “straight” Medicare can qualify for nursing home rehabilitation.
Medicare rehab coverage is provided under Part A hospital insurance, with two key provisions being that (1) seniors are only eligible for rehabilitation after a 3-night stay in a hospital as an inpatient, and (2) nursing home rehab is limited to 100 days per hospitalization period.
Federal Medicare administrators recognize that hospital and nursing home beds will likely become limited commodities in the coming weeks. That means some who should have hospital care will be denied in favor of needier patients, and some who would benefit from facility-based rehab will not be able to access it, possibly becoming more infirm due to the lack of intervention. In light of this, the Medicare Administrator issued a “special finding” that waives both of these limitations, in most cases.
SNF [skilled nursing facility] care without a 3-day inpatient hospital stay will be covered for beneficiaries who experience dislocations or are otherwise affected by the emergency, such as those who are (1) evacuated from a nursing home in the emergency area, (2) discharged from a hospital (in the emergency or receiving locations) in order to provide care to more seriously ill patients, or (3) need SNF care as a result of the emergency, regardless of whether that individual was in a hospital or nursing home prior to the emergency.
In addition, we will . . . provide renewed coverage for extended care services which will not first require starting a new spell of illness for such beneficiaries, who can then receive up to an additional 100 days of SNF Part A coverage for care needed as a result of the [COVID-19] emergency.
Seema Varma, Administrator, Centers for Medicare and Medicaid Services
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