The midnight rule means that if the resident is not in his/her Medicare A bed at
midnight that the preceeding day cannot be billed for Medicare A and should therefore
not be included in counting the Medicare A day towards the PPS MDS cycle. Example,
the resident is in the Emergency room the midnight of his 9th day in your facility.
You had planned on using day 11 for the ARD of his 14 day PPS assessment. You now have
to move that ARD to be the day after you had planned, because his day 9 no longer
counts and his 10th day in your facility now becomes his Medicare day 9. When you do
his 14 day assessment you still count back 7 days and use the information for all 7
days, but cannot count or get paid for the original day 9 for Medicare purposes. You
do not need to start over at day 1 just because a resident is out of his bed at
midnight. I probably didn't make this very clear.
The data you are looking for is found on page 2-38 of the revised manual. Look under
the heading of "Resident admitted to an Acute care facility and returns." The second
paragraph under that heading discusses the midnight rule."
-----Original Message-----
From: MDS <[EMAIL PROTECTED]>
Sent: Oct 27, 2003 7:17 AM
To: [EMAIL PROTECTED]
Subject: Midnite rule
Is my brain fried or did I see something about midnite rule no longer in
effect, you just do not bill for that day, that LOA can be more than 1 day.
Please remind me where to go find data. Thanks
Dawn Freeman, LPN
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