42 C.F.R. § 409.34
Criteria for “daily basis”
(a) To meet the daily basis requirement specified in § 409.31(b)(1), the following frequency is required:
(1) Skilled nursing services or skilled rehabilitation services must be needed and provided 7 days a week; or
(2) As an exception, if skilled rehabilitation services are not available 7 days a week those services must be needed and provided at least 5 days a week.
(b) A break of one or two days in the furnishing of rehabilitation services will not preclude coverage if discharge would not be practical for the one or two days during which, for instance, the physician has suspended the therapy sessions because the patient exhibited extreme fatigue.
Notes of Decisions
Cited in 3
cases, 1987–1988 · leading case: Fox v. Bowen, 656 F. Supp. 1236 (D. Conn. 1987).
Fox v. Bowen, 656 F. Supp. 1236 (D. Conn. 1987). “42 C.F.R. § 409.34 provides, inter alia: (a) To meet the daily basis requirement specified in § 409.”
Duggan v. Bowen, 691 F. Supp. 1487 (D.D.C. 1988). “” See 42 C.F.R. § 409.34 (a)(1) (1987). It is hard to understand how defendants can consider “daily” to mean 7 days a week when the term functions as an entrance requirement to a skilled nursing facility while in this context, where it functions to exclude a person from…”
Hirsch v. Bowen, 655 F. Supp. 342 (S.D.N.Y. 1987). “31 (b)(1) did not meet the daily care requirement of 42 C.F.R. § 409.34 . As a result, the Magistrate ruled that Hirsch was not entitled to Medicare benefits.”
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