Stephen Edward Samuelian | Medicare Part A
Medicare Part A recipients may be eligible for in-patient skilled nursing care services. Stephen Edward Samuelian reports this includes medications, dietary counseling, and semi-private accommodations.
LAGUNA BEACH, California – June 15, 2015 – Medicare Part A covers, under certain conditions, skilled nursing services provided at an approved Skilled Nursing Facility (SNF), says Stephen Edward Samuelian of Covenant Care, Inc. Medicare Part A is known as Medicare Hospital Insurance and covers, for a limited time, the following services:
- Skilled nursing services (Stephen Edward Samuelian notes that this is defined as medical services more complicated than can be administered by a non-licensed provider or at home)
- Semi-private accommodations
- Physical therapy
- Occupational therapy
- Equipment and medical supplies
- Ambulance transportation (This is limited to times when other means of transportation is a health hazard, clarifies Stephen Edward Samuelian)
- Dietary and nutritional counseling
- Medical social services
- Speech pathology services
According to Stephen Edward Samuelian, some of these services are covered only if they are necessary for the medical recovery of the patient.
It’s of interest to note that Medicare also offers the same coverage for “swing bed services” offered by a hospital. Swing Bed service means that a facility has sanctioned one or more beds in a unit for use as Skilled Nursing Service beds, explains Stephen Edward Samuelian. In these cases, Medicare must have knowledge of a pre-existing agreement between the facility and the Department of Health and Human Services.
Stephen Edward Samuelian points out that should the patient require hospitalization mid-SNF stay, he or she is not guaranteed a bed at the most recent facility they resided once released. However, the patient may, potentially at their own cost, request a bed held.
Individuals needing skilled nursing care services are eligible for Medicare coverage only if they meet all the required conditions. Stephen Edward Samuelian lists these as:
- Current Medicare coverage, with SNF days left in benefit period
- A physician has determined medical need
- Facility is Medicare certified
- Condition requiring services were hospital related or begun during a SNF stay (Stephen Edward Samuelian explains the new condition must occur during the course of a SNF stay that was the result of a hospital-related medical condition)
- Have had three days inpatient hospital admission
Stephen Edward Samuelian reports that a physician may require observation services while the patient is in the hospital. These “observation days” do not count toward the three required in-patient stays needed for Medicare SNF coverage.
Loss of coverage
Individuals covered under Medicare Part A may lose their coverage if they refuse doctor-ordered skilled care services such as IV medication or therapy. Stephen Edward Samuelian notes that if SNF services are completed but required again at a later date, the patient must have a new qualifying three day hospital stay to resume eligibility.
Skilled care checklist
Stephen Edward Samuelian notes that, while each certified facility is held to uniform standards, Medicare provides a checklist to help patients determine which facility is best for their situation. Items on this checklist include a visual assessment of living spaces, observation of staff/patient relationships, and confirmation of basic to advanced safety and care services, according to Stephen Edward Samuelian.
Stephen Edward Samuelian asserts that Medicare.gov offers the most current information on SNF coverage and provides a facility comparison tool for Medicare recipients.
Stephen Edward Samuelian is the founder of Covenant Care, Inc. as well as Utah’s Haven Health Group. He is an expert in the design of specialty medical facilities and has overseen construction on dozens of Skilled Nursing Care centers throughout the Midwest.