Can my parents access a nursing home without a hospital stay?

Rebecca asked...

I heard that it is possible to get my parent into a rehab or nursing home without a hospital stay and still have it covered by Medicare. Is this true? How does it work?

Expert Answer

check again with the source where you heard that, because Medicare Part A coverage for inpatient skilled nursing or rehabilitation facility care has strict rules requiring a prior hospital stay. In order for Medicare to cover an inpatient stay in a skilled nursing or rehabilitation facility, admission to the facility has to begin within 30 days after your parent has spent at least three consecutive days, not counting the day of discharge, in the hospital.

The only general exception to this rule is if your parent leaves the nursing or rehab facility after Medicare Part A coverage begins, but is then readmitted to the facility within the next 30 days. In that case, Medicare Part A continues to cover the nursing or rehab facility stay without any requirement of a new hospital stay.

To see the official Medicare explanation of these rules, take a look at their booklet Medicare Coverage of Skilled Nursing Facility Care.