Definition of Hospital or SNF for Ending a Benefit Period

10.4.3 - Definition of Hospital or SNF for Ending a Benefit Period (Rev.10880, Issued: 08-06-21, Effective: 11-08- 21, Implementation: 11-08-21) It is important to note that a benefit period cannot end while a beneficiary is an inpatient (see §10.4.4) of an institution that meets the basic definition of a “hospital” at §1861(e)(1) of the Social Security Act (the Act), even if the hospital does not meet all of the additional requirements that are necessary for starting a benefit period, as discussed further in §10.4.3.1 below (see also §1861(e) following (9) of the Act and the regulations at 42 CFR 409.60(b)(1)). Similarly, a benefit period cannot end while a beneficiary is an inpatient (see §10.4.4) of an institution that meets the basic definition of a “SNF” at §1819(a)(1) of the Act, as discussed further in §10.4.3.2 below. As noted in §2164 of the State Operations Manual (Pub. 100-07), Chapter 2, all hospitals and SNFs that are Medicare-certified are automatically considered to meet the applicable basic definition in this context by reason of the Medicare certification itself. Moreover, even an institution (or portion of an institution) that is not certified for Medicare can serve to prolong an inpatient’s benefit period if it meets either the basic “hospital” or “SNF” definition discussed above.