Discharge or Death on First Day of Entitlement or Participation

20.1.3 - Discharge or Death on First Day of Entitlement or Participation (Rev. 1, 10-01-03) A3-3103.4, A3-3135.4, HO-216.4, SNF-242.4 For SNF services, the cost of such services has been built into the SNF PPS base. This makes the PPS per diem somewhat higher than it would otherwise have been for all of the preceding SNF days that Part A does cover, even though the day of discharge itself is not a covered Part A day: • A patient is admitted prior to the first day of entitlement and dies or is discharged from a participating hospital on the first day of entitlement; or • A patient in a noncovered stay in a nonparticipating hospital dies or is discharged on the first day the hospital becomes a participating hospital. For a late discharge on such a day, the rules in §20.1.1 will be followed. For SNF services, Medicare does not pay for accommodations on the day of discharge or death. Medicare pays for ancillary services (under Part A) when a patient dies or is discharged on the first day a facility becomes a participating facility and the other requirements for coverage of extended care services are met. Although a day of utilization is not counted in these situations, a benefit period begins and any charges for covered services are applied against the inpatient hospital deductible.