b. Nonavailability of appropriate bed space in a participating SNF

Official source

Intervals of up to 28 days were permitted where transfer to a participating SNF (for this purpose a “participating SNF” includes only those facilities participating under title XVIII) was deferred under the following conditions:

1. The individual required within the 14-day period after the hospital discharge, and continued to require through admission to the SNF, a covered level of SNF care for a condition for which they received inpatient hospital care, and they met all other extended care requirements and either 2) or 3) below.

2. There was no bed available in the facilities ordinarily utilized in the geographic area in which the beneficiary resided. (A private room is considered an “available bed” for this purpose.) The geographic area in which a beneficiary resides should be defined in such a way that a patient would not be taken away from their family and transported over great distances;

3. There was an available bed in an SNF but it did not constitute appropriate bed space for the patient. In determining whether appropriate bed space was available, consideration should be given only to whether the facility in which a vacant bed was available had the capacity to meet the individual's medical needs, i.e., was capable of providing the required skilled services. Such nonmedical considerations as the individual's or their physician's preference for a particular SNF should not be considered.

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b. Nonavailability of appropriate bed space in a participating SNF

Official source

Intervals of up to 28 days were permitted where transfer to a participating SNF (for this purpose a “participating SNF” includes only those facilities participating under title XVIII) was deferred under the following conditions:

1. The individual required within the 14-day period after the hospital discharge, and continued to require through admission to the SNF, a covered level of SNF care for a condition for which they received inpatient hospital care, and they met all other extended care requirements and either 2) or 3) below.

2. There was no bed available in the facilities ordinarily utilized in the geographic area in which the beneficiary resided. (A private room is considered an “available bed” for this purpose.) The geographic area in which a beneficiary resides should be defined in such a way that a patient would not be taken away from their family and transported over great distances;

3. There was an available bed in an SNF but it did not constitute appropriate bed space for the patient. In determining whether appropriate bed space was available, consideration should be given only to whether the facility in which a vacant bed was available had the capacity to meet the individual's medical needs, i.e., was capable of providing the required skilled services. Such nonmedical considerations as the individual's or their physician's preference for a particular SNF should not be considered.