CMS Provides Clarification on the End of the 3 Day Stay Waiver

With the public health emergency ending on May 11, there have been many questions regarding some of the waivers that were put in place during COVID.

Under one of these waivers, the traditional qualifying 3 day inpatient hospital stay was not required in order to trigger Medicare coverage of a skilled nursing facility stay.  On a recent conference call, CMS provided clarification on this waiver.  For any Medicare residents admitted on May 11, 2023 or earlier, the 3 day stay requirement is waived.

Any Medicare residents admitted on May 12, 2023 or later will require a 3 day inpatient hospital stay for Medicare coverage in the SNF.  Under PDPM guidelines, any Medicare resident admitted May 11, 2023 or earlier, who leaves the facility and does not return to the facility within 3 calendar days, will require a 3 day inpatient hospital stay for continued Medicare coverage. Any Medicare resident who returns within 3 calendar days and is continuing the previous stay does not require a 3 day inpatient hospital stay for continued Medicare coverage.