For Sam to be eligible for Medicaid-paid skilled nursing home care, until which date must he stay in the hospital?

To be eligible for Medicaid-paid skilled nursing home care, an individual typically needs to have a qualifying hospital stay that lasts at least three consecutive nights, or three midnights. The three-midnight rule requires that the patient must have been an inpatient in the hospital, not under outpatient observation, for this duration.

In this scenario, if Sam is planning to transition to skilled nursing care immediately after his hospital stay, he must ensure that he is discharged from the hospital on the fourth day after admission. This means that if he is admitted on June 1, he would need to stay until June 4 to meet the requirement of three full nights (June 1, June 2, and June 3). Therefore, the correct answer is June 4, as it is the last day he must stay in the hospital to qualify for Medicaid coverage for skilled nursing care.