The Jimmo Settlement, approved by the federal district court in 2013, confirmed Medicare coverage should be determined by a beneficiary’s need for skilled care, not the individual’s potential for improvement; and that Medicare covers skilled care to maintain an individual’s condition or slow decline. CMS revised Medicare policy manuals, guidelines, and instructions to reflect these principles per Court approved settlement.
A clear message from CMS is available at https://www.cms.gov/medicare/settlements/jimmo.