HI 00601.140 Daily Skilled Service

Skilled nursing services or skilled rehabilitation services must be required and provided on a “daily basis”—i.e., on essentially a 7-day-a-week basis. However, if skilled rehabilitation services are not available on a 7-day-a-week basis, a patient whose inpatient stay is based solely on the need for skilled rehabilitation services would meet the “daily basis” requirement where they need and receive such services on at least 5 days a week. Accordingly, where a facility provides physical therapy on only 5 days a week and the patient in such a facility requires and receives physical therapy on each of the days on which such is available, the requirement that skilled rehabilitation services be provided on a daily basis would be met. A break of a day or two during which no skilled rehabilitation services are furnished and discharge from the facility would not be practical would not violate the requirement. For example, a patient who normally requires skilled rehabilitation services on a daily basis exhibits extreme fatigue which causes their physician to suspend therapy sessions for a day or two. Payment would be made for these days since discharge in such a case would not be practical.