A hospital stay that ends in a transfer to a skilled nursing facility puts most families in contact with Medicare’s rehabilitation benefit for the first time. The coverage is genuine but narrow, and it rests on conditions decided during the hospital stay rather than at the nursing home. By the time someone is told coverage is ending, the facts that decided it are already fixed.
Medicare nursing home coverage in Texas runs under Part A as what the statute calls post-hospital extended care services, and two limits account for most of the denials families encounter. The stay has to follow a qualifying hospital admission, and the benefit is capped at 100 days per spell of illness under 42 U.S.C. § 1395d(a)(2)(A). Neither limit is within the facility’s discretion. McCulloch & Miller works with families in Austin, Houston, and across Texas on Texas elder law questions that begin at exactly this moment.
What Medicare Nursing Home Coverage in Texas Pays For
Post-hospital extended care services are skilled nursing or rehabilitation services furnished in a skilled nursing facility after a qualifying transfer from a hospital, covered by Medicare Part A for a limited number of days rather than as ongoing long-term care.
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