Medicare Benefit Policy Manual (Pub. 100-02), Ch. 8 § 20.3.1.6
Impact on Spell of Illness
20.3.1.6 - Impact on Spell of Illness
(Rev. 1, 10-01-03)
The SNF days during the sanction period will be used to track breaks in the spell of
illness. A beneficiary’s care in an SNF met the skilled level of care standards if a
Medicare SNF claim for the services provided in the SNF was denied on grounds other
than that the services were not at a skilled level of care. If the patient is receiving a
skilled level of care the benefit period cannot end.