C. Continuing a benefit period

It is important to note that for purposes of continuing a benefit period the hospital or SNF in which the stay occurs need not meet all of the requirements that are necessary for starting a benefit period.

Inpatient services will prolong the beneficiary's benefit period if the hospital is primarily engaged in providing, by or under the supervision of physician(s), to inpatients:

1. diagnostic and therapeutic services for medical diagnosis, treatment, and care of, or rehabilitation services to injured, disabled, or sick persons; or

2. psychiatric services for the diagnosis and treatment of mentally ill persons; or

3. medical services for the diagnosis and treatment of tuberculosis.

Participating hospitals will always meet this requirement. For nonparticipating hospitals see the Directory of Medical Facilities.

A stay in a hospital outside the United States prolongs a spell of illness. It may be assumed, in the absence of contrary evidence, that a foreign hospital in which a beneficiary spent one or more days meets one of the above requirements and that the beneficiary's statement about length and place of stay is correct.

Similarly, inpatient services in a SNF or nonparticipating nursing facility prolong a beneficiary's benefit period if the facility meets at least the requirement that it is primarily engaged in providing to inpatients skilled nursing care and related services for patients who require medical or nursing care, or rehabilitation services for injured, disabled, or sick persons. Participating SNF's always meet this definition. For nonparticipating facilities see the Directory of Medical Facilities.