As the Covid-19 public health emergency ends, many older adults who need a post-hospital stay in a skilled nursing facility (SNF) will be in for an unpleasant surprise: Traditional Medicare may not pay.
And it gets more confusing. Medicare encourages hospitals to keep observation patients for the shortest time possible, usually less than 48 hours. This is, weirdly, called the “two-midnight rule.” But sometimes patients stay longer. Others may split their time between observation and inpatient status. No matter, if they are not admitted as a hospital inpatient for at least consecutive three days, Medicare will no longer pay for SNF care.
An after a long wait in the emergency room and two days in a hospital bed, she likely will be weak and debilitated. And she may have no family member to care for her at home. But if she is discharged to a SNF to get her strength up, it will be on her dime. Medicare won’t pay. Truth is, the explicit purpose of this rule is to reduce Medicare’s hospital and SNF costs. It encourages outpatient orthopedic surgeries because they cost less for similar outcomes.
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