Ask the Experts

Ask the expert: Skilled care confusion

Q: When a resident in a SNF exhausts their 100 days of Medicare, can they be re-skilled after a 3-day hospital stay if they have been on a tracheotomy tube the whole time?

A: In order to generate a new 100 day benefit, the beneficiary needs to go 60 consecutive days without skilled care being delivered. The question you need to ask is whether or not you are providing any skilled care to the resident with the tracheotomy tube. It sounds unlikely, but really is not enough information to make the call.  It’s not the tracheotomy tube that is skilled, but whether or not you are providing skilled care, which could include observation and assessment.