Certified Senior Advisor (CSA) Practice Test

To qualify for Medicare coverage in a skilled nursing facility, one of the primary requirements is that the individual must require daily skilled nursing care. This means that there must be a medical necessity for skilled care, which can include services such as nursing care, physical therapy, speech therapy, or occupational therapy that can only be provided by licensed professionals.

Medicare Part A covers skilled nursing facility care for a maximum of 100 days, provided that the individual meets all eligibility criteria, including having a qualifying hospital stay of at least three days prior to admission. The need for rehabilitation services alone does not automatically qualify a patient for Medicare coverage, as it is the skilled nursing care that is a critical factor in determining eligibility. Simply being admitted from a home setting does not ensure coverage, nor does a shorter stay negate the need for skilled care as a primary requirement.

Therefore, requiring daily skilled nursing care is essential for being eligible for Medicare coverage in a skilled nursing facility.