Association Between High Discharge Rates of Vulnerable Patients and Skilled Nursing Facility Copayments

Medicare pays for 100% of postacute care provided by skilled nursing facilities (SNFs) during the first 20 days within a benefit period. However, on the 21st day, most patients become responsible for a daily copayment of more than $150. This copayment may present a significant financial burden for some patients—particularly those with limited economic means—and motivate them to discharge from SNFs on the 20th day of care based on their financial resources rather than their recovery status. In this article, the researchers examine whether patterns of SNF discharge are associated with this change in Medicare payment responsibility on day 20.