What is a key requirement for skilled nursing facility care coverage under Medicare?

A key requirement for skilled nursing facility care coverage under Medicare is the necessity of a prior three-day hospital stay for a related illness. This stipulation is integral because it establishes that the individual has undergone significant medical treatment that necessitates continued care in a skilled nursing facility. The individual's condition must be stable enough to transition from hospital care to skilled nursing, which is designed to provide rehabilitation and necessary medical oversight.

This rule ensures that Medicare only covers skilled nursing services for individuals who really need it following a hospital stay related to their illness or injury. The three-day hospitalization acts as a qualifying event that verifies the need for further care, ensuring that coverage is not provided for unrelated conditions or purely custodial care. Thus, when an individual enters a skilled nursing facility after a qualifying hospital stay, Medicare is more confident in the necessity of the skilled services being requested.