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Did You Know?

Medicare Will Not Pay for a Nursing Home if You’re Under Outpatient Hospital Status

A patient can be in a hospital receiving medical care, tests, medications, overnight accommodations and meals, but may still be considered an outpatient as far as Medicare is concerned. The classification between outpatient/observation status versus inpatient status may not be obvious in regards to patient care, but the distinction will determine whether or not Medicare will pay for rehabilitation in a skilled nursing facility following the hospital stay. In order for Medicare to cover post-hospital nursing home care, there is a three-day hospital inpatient requirement.

If a patient is unsure about their inpatient/outpatient status, they should ask their physician or a member of the care team. The Notice Act, effective August 6, 2016, requires hospitals to provide written and oral notice within 36 hours to patients who have observation/outpatient status for more than 24 hours. To read more about how the Centers for Medicare and Medicaid Services (CMS) will implement the act, go to www.medicareadvocacy.org or click here to read more.

Page Last Modified: May 4, 2016