COVID-19 EMERGENCY DECLARATION: Health Care Providers Fact Sheet

One key element is the suspension of the three midnight hospitalization requirement for qualifying for Medicare to pay for someone’s skilled nursing facility stay. That is a big issue for hospitals, and allows them to quickly discharge patients in order to free up room. 

“Amid the Covid-19 pandemic, we are facing a national shortage of hospital beds. The federal government has taken the critical step of suspending the “Skilled Nursing Facility qualifying stay.” CMS is waiving the requirement of Section 1812 (f) of the Social Security Act. This section stipulates that for patients with Traditional Medicare, the costs of care received at a skilled nursing facility (SNF), is covered only if there is a 3 midnight inpatient hospitalization, prior to the SNF admission. With the suspension of this requirement, hospitals may transfer the noncritical patients, once stabilized, to a lower level of care, freeing up much-needed hospital beds. Some of the provisions include; waiving of the 3 midnight qualifying inpatient hospital stay prior to admission to a SNF authorizes renewal of SNF coverage, to certain beneficiaries who have recently exhausted these benefits allows hospitals to house acute care in patients in otherwise excluded, distinct parts of the facility. For example, if a SNF, or acute rehab facility is colocated within the acute care hospital, these beds may be repurposed for acute inpatient care.

Critical access hospitals are no longer limited to 25 beds, and may expand their capacity. Patients requiring acute inpatient psychiatric (IPP) care, may be relocated, to an acute medical unit, if there is documentation of capacity issues or other exigent circumstances. For example, if an IPP patient requires isolation in the acute medical facility due to Covid 19 infection, the patient will (for billing purposes) to remain under the umbrella of IPP. It would be presumed that patients that present to an acute care hospital, and cannot be transferred to a IPP due to capacity issues or isolation requirements, would also be appropriate for IPP billing, as long as they are receiving appropriate IPP care and meet IPP admission criteria.”

Full details can be found here.