If you do a discharge return anticipated and they don’t come back right away do we do a regular admit or do we do the return readmission?  The time in between is  from 3-4-11 to 4-15-11. 

The CAA worksheets in the RAI manual.  Are they required or can we use what the software provider offers in our system. Do we then also have to complete the worksheets if we use what is in our system? 

In regards to the question, “when we do the 5 day assessments to get a RUG for our PPO's, I was told not to submit that assessment b/c it violates HIPPA. My question is after this assessment has been completed do we print it out and put it in their record, or can we delete it out of our system?”

When we do the 5 day assessments to get a RUG for our PPO's, I was told not to submit that assessment b/c it violates HIPPA. My question is after this assessment has been completed do we print it out and put it in their record, or can we delete it out of our system?

I had a resident admitted for skilled services on 3/26.  I did an entry record on him and we completed a 5d admission MDS which was submitted and accepted.  He then chose to go Hospice on 4/1.  I just did a significant changed MDS on 4/11 for the transfer to Hospice but then on 4/12 he revoked his Hospice services and returned to skilled status.  This is what we have come up with for future MDS’s-  please let me know if I am correct or not.

4/18: significant change/5d MDS for therapy, no longer hospice. 

4/21: 14 day MDS

4/26: 30 day MDS to keep him in the original date schedule from his admission since he never left the facility

If a 60day would be needed I would pick a date between5/14 and 5/24

Does an end of therapy need to be filed if resident is recieving IV therapy on SNF when they have completed the IV therapy?

A resident was admitted to the facility on Medicare. At the time of admission the information that was received was that the resident had 100 days of Medicare Part A coverage. The PPS schedule was adhered to with the information that was given on admission. The 5 day, 14 day and 30 day assessments were completed before the resident discharged from the facility. I have just found out from the billing department that this resident only had one day of Medicare coverage upon admission to the facility. I am wondering how to proceed with this. I believe that both the 14 and 30 day assessments should be inactivated. 

The 5 day assessment was done with Day 8 as the ARD. My supervisor says that Day 8 still can be used as the ARD. I am not in agreement to this since he only had one day of coverage.

At the very least a correction will have to be done to Section A2400C (last day of Medicare coverage) on the 5 day assessment and the resident's discharge assessment. Am I correct in regard to the ARD on the 5 day assessment? Would this assessment have to be inactivated (the ARD cannot be changed on an assessment) and will the default payment rate be applied to this assessment?

In the event that a resident was at the hospital for greater than 24 hours and not admitted does is the facility required to complete a discharge assessment and then a reentry upon return to the facility. If the resident is receiving the services of Medicare Part A how does this affect the resident's Medicare days in conjunction with the PPS schedule? Does the Medicare PPS schedule resume at the point that they left the facility for observation at the hospital or does the calendar resume with a 5 day assessment.

When you have a resident whose medicare is paid by a PPO, do you code the 5 days as a PPS 5-day assessment or do you use the other code.  The issue is arising because the PPO's want to have the RUGS category. If we code the 5 day PPS, then it will be submitted to MC.  Not a billling issue because are not paid until UB is sent.

For a medicaid res who was dischared return anticipated to the hospital, when that res returned to the facility and 1 month later had a scheduled assessment, when answering the A1600 and if you enter the hospital reentry date and A1700 is coded as a reentry, when section complete it give a warning that the date is out of range.  Why would it tell us that the date is out of range?

Our facility just sent a new coordinator for 3.0 training and she was told that we are not required to use the ARD date or the day before but we have the look back period for the interview.  What are your thoughts?

In the RAI manual, it states that it is preferable to do the interview on the day before or the day of the ARD but it doesn't state that it's required.  What are your thoughts on this statement?