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Appealing a skilled-nursing or rehab discharge

If a rehab center, skilled-nursing facility, or hospital tells you Medicare coverage is ending and you don’t feel ready to leave, you have the right to a same-day fast-track appeal— and you stay covered while it’s reviewed. It’s free, and denials for skilled-nursing stays are overturned about 95% of the time on appeal.

Time-sensitive — act today

Call the appeal number by noon the day before the discharge date on your notice. Meet that deadline and you generally are not charged for the extra days while the reviewer decides.

What to do, step by step

  1. 1Get the notice in writing. The facility must give you a “Notice of Medicare Non-Coverage” at least two days before coverage ends. It lists the date coverage stops and the phone number for your regional appeal organization (the BFCC-QIO).
  2. 2Call that number and ask for a “fast appeal.” Use the phone number printed on your notice — it routes to the Quality Improvement Organization (Livanta or Acentra/Kepro, depending on your state) that handles these. Call by noon the day before the listed end date.
  3. 3Say you don’t agree the stay should end. You don’t need medical language. “I’m being discharged and I don’t think I’m ready. I want to file a fast appeal.” They will ask the facility for your records.
  4. 4Stay put while they review. The reviewer usually decides within about 48 hours. You keep coverage during the review, and if you filed on time you aren’t billed for those days even if you lose.
  5. 5If they say no, you can escalate. A quick reconsideration is available, and your doctor can add a letter of medical necessity. Ask the facility for a copy of the “Detailed Notice of Discharge” — it states their reasoning, which you can rebut.
Works for both kinds of Medicare. This fast-track process applies whether you have Original Medicare or a Medicare Advantage plan — the deadlines and the reviewer are the same. If you have a Medicare Advantage plan and the fast appeal is denied, your case is automatically forwarded to an independent reviewer.
← See denial & appeal rates by Medicare Advantage insurer

Based on Medicare’s expedited-determination rights (42 CFR 405 & 422 Subpart M). SNF overturn figure: HHS Office of Inspector General. Content reviewed July 2026. Informational only — not medical, legal, or billing advice. The appeal phone number on your own notice always governs.