NaCCRA Forum: Assisted Living & Skilled Nursing

The issue is, "Medicare will only cover rehabilitation (post-hospital care) in a facility if the beneficiary was first admitted to a hospital (in-patient) for a period of at least three days, not including any days on observation status".

NOTE: Observation status, becoming more common, is covered under Part B, not hospital Part A, which can prevent beneficiaries from receiving up to 100 days of nursing facility coverage.

Our CCRC contract covers us if we return to campus from a hospital stay sooner than 3 days, or return from a same-day surgery center, something common now for even hip-replacement surgery.

Linda Kilcrease

Resident of a CCRC

I live in a CCRC in Maryland, managed by Erickson Senior Living (ESL). ESL also has Medicare Advantage Plan for the residents in their CCRCs. I believe that plan covers the nursing care costs for residents returning to nursing care as if the hospital stay had been three days. i do not know details at the moment.

Yes, Leslie...it does make sense. However hospitals in our area are not always easy to persuade on the 3 night issue. Some of our residents wonder if any other CCRC life plans life plans have coverage to fill the financial gap when nursing/rehab is needed after a shorter hospital stay. thanks...

Then it makes sense to admit them for the three night observation status.

Our Harbor's Edge Health committee has been asked whether any communities have Nursing care payment plan for residents returning from hospital stay involving less than 3 nights but requiring follow up care. In VA a three night stay is required for Medicare to pay for follow up nursing care. Heather Martin