Three midnight rule

September 18, 2008

Medicare requires patients to stay three nights before qualifying for benefits at a skilled nursing facility.

Many times, patients can be stabilized and ready for transfer within 1-2 days, but because of this Medicare rule have to stay an extra night for no reason.

When I was working in the hospital, I wondered the same thing as The Happy Hospitalist:

In essence, the arbitrary rule penalizes great medical care. When you do everything right. When you are so good that you get your medical issues resolved quickly, ahead of the 87 year old’s ability to recovery physically and mentally, you are penalized by not allowing the patient to move on to the next level of care.

If Medicare is serious about saving money, it should take a hard look into this.



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  4. Exception to the rule
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  6. The single-payer backdoor
  7. Taking a stand against futile care


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{ 1 comment }

1 Anonymous September 19, 2008 at 1:32 am

I’ve seen the exact opposite. Hospitals have to justify the 3-night stay and thus boot patients unless they’re basically on life support.

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