If you are discharged from the skilled nursing facility and readmitted in the same benefit period, Medicare will continue to pay for services until you have reached the 100 days of coverage. A benefit period begins when you are admitted to a hospital for an in-patient stay. It ends when you have been out of the hospital or skilled nursing facility for 60 straight days or you have been in a skilled nursing facility but have not received skilled care for 60 straight days. Medicare will no longer pay for nursing home care when you have reached the 101st day, or before the 101st day if you no longer need skilled nursing or rehabilitation services. When you no longer need skilled care, you are said to need custodial care.
Custodial care is help with eating, bathing, taking medicine, and going to the bathroom.
Medicare will not pay for custodial care at home or in a nursing facility if that is the only care you need. If you have questions about Medicaid paying for custodial nursing home care, see your local Medicaid representative. The hospital social worker can direct you to the nearest Medicaid office. The facility's administrator or director of nursing should be contacted when you have concerns. If your problem is not taken care of, call the local ombudsman.