Residents of skilled nursing facilities can temporarily leave their facility without losing Medicare coverage, according to a notice from the Center for Medicare Advocacy (www.medicareadvocacy.org).
“An outside pass or short leave of absence for the purpose of attending a special religious service, holiday meal, family occasion, going on a car ride, or for a trial visit home, is not, by itself evidence that the individual no longer needs to be in a SNF for the receipt of required skilled care” (Medicare Benefit Policy Manual, Pub. 100-02, Ch. 8, '30.7.3).
If the resident returns to the facility by midnight, the facility can bill Medicare for the day’s stay (Medicare Benefit Policy Manual, Pub. 100-02, Ch. 3, '20.1.2).
If the resident returns to the facility after midnight, the day the resident leaves is considered a leave of absence day. While the facility cannot bill Medicare for leave of absence days, it also cannot bill the beneficiary for those days (Medicare Claims Processing Manual, Pub. 100-04, Ch. 6, '40.3.5.2).
