The guidelines for Medicare skilled nursing facility care and home health care services can be confusing. While Medicare will cover home health care for as long as the patient is eligible, skilled nursing care and home health care are available only on a part-time or "intermittent" basis. The Medicare Home Health Agency Manual defines intermittent as "skilled nursing care that is either provided or needed on fewer than seven days each week, or less than eight hours each day for periods of 21 days or less." Exceptions are permissible under "exceptional circumstances when the need for care is finite and predictable." 1

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