Skilled Nursing Facility
A licensed facility providing 24-hour skilled nursing and rehabilitation services for patients recovering from hospitalization; Medicare covers up to 100 days per benefit period following a qualifying 3-day inpatient hospital stay.
A skilled nursing facility (SNF) provides a level of care between hospital and home — 24-hour nursing supervision plus skilled services like physical therapy, occupational therapy, speech therapy, IV medication administration, and complex wound care. Medicare's SNF benefit is only available following an inpatient hospital admission of at least 3 consecutive days (not counting the discharge day), known as the "3-day rule."
The Medicare coverage structure for SNF is: days 1–20 covered at 100% (no coinsurance); days 21–100 require $204/day coinsurance (2024); days 101+ not covered by Medicare at all. The average SNF stay covered by Medicare is 27 days. After Medicare coverage expires, patients pay privately at $250–$400+/day for a semiprivate room ($91,250–$146,000/year) unless Medicaid coverage or long-term care insurance applies.
Distinguishing between custodial care (help with activities of daily living — bathing, dressing, eating) and skilled care is critical for Medicare coverage. Medicare never pays for purely custodial SNF care. When a patient's condition has stabilized and skilled services are no longer needed, Medicare coverage ends regardless of whether the patient is strong enough to return home.
Real-World Example
Following a 5-day hospitalization for a stroke, a patient transferred to an SNF for 45 days of rehabilitation; Medicare covered days 1–20 fully and days 21–45 at $204/day coinsurance, for a total patient out-of-pocket of $5,100 — then she returned home with outpatient therapy.