For skilled nursing facilities it's a struggle to stay ahead of the Medicare initiatives and market forces that are causing hospitals and health systems to narrow their post-acute care networks. With so many competing priorities — the alphabet soup of BPCI, ACOs, VBP, etc. — it can be hard to stay ahead of all the changes.
For skilled nursing facilities, the Medicare SNF 3-day rule can make it difficult to place the right patients in the right setting at the right time. The 3-day rule requires that a Medicare beneficiary spend three nights in a hospital as an inpatient — observation stays do not count — before becoming eligible for Medicare-covered SNF care. This rule creates a challenge for SNFs as hospital lengths of stay decline for many of the conditions that SNFs treat.