This is true.  A hospice resident may receive Medicare part a benefits at the same 
time.  The catch is, though, that that both must be billed for 2 different skilling 
reasons.  The reason you are covering the resident under Medicare Part A cannot be the 
same reason they are being covered under hospice.  

You can skill a resident under Part A as you described below.  If this resident will 
benefit from therapy and will help make remaining life span more enjoyable and 
independent, then by all means, skill him under med a.  I have had several that we 
skilled under part a for end-of-life when they had come back from the hospital and we 
gave iv pain medication, etc.  

Brenda W. Chance, RN, RAC-C
MDS Coordinator
 
 
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-----Original Message-----
From: Corey [mailto:[EMAIL PROTECTED] 
Sent: Tuesday, November 18, 2003 12:47 PM
To: [EMAIL PROTECTED]
Subject: Re: Use of grace days/back to basics

It is possible to use the Medicare A days with a hospice patient, and in
some cases at the same time.  In this case, you can pick him up for the
skilled reasons (IV in hospital, new diabetes with insulin), (order
changes?) possible therapy.

Also, just because a patient is terminal doesn't mean that they can't
benefit, even temporarily, from therapy.  Is therapy saying he can not
benefit in current condition, or rather "Why bother?".  Hospice can pick the
patient up after the Part A stay.
Corey
----- Original Message -----
From: <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Tuesday, November 18, 2003 8:02 AM
Subject: Re: Use of grace days/back to basics


> So is sec t optional? Once you answer the question ordered therapies or
does the order have to state start within the next 14 days? My old software
would not allow me to estimate if I didn't have the 65 mins, current
software gives error message and requires estimated mins entered. My current
therapy contract pay the therapist just 9$ day for any skilled resident that
is in a medical rug, so I would prefer to get my se3 from the hospital info
but end up using grace days to capture a therapy rug due to the software
requiring estimating.
>
> also had a new one this week: res returned from hospital with new dx of
cancer with mets and poor prognosis, he was also started on insulin, new med
and had orders for snf level of care, I was going to do the 5 days and d/c
but therapy eval and I got a couple of different stories that they were
going to pick up but when questioned by the corp nurse consultant they
stated they didn't know why they were seeing him, per her report. Hospice
screened and report I got back was they would pick him up when his skilled
stay was over. (never heard of that before) I know I have read on the list
server that people were skilling people even tho terminal if they would
benefit from it so when therapy stated they would pick him up was not too
suprised and they even discussed setting the 14 day ard, so sounded like
they were going to be providing ongoing therapy. Not sure what the question
here is but I feel better.....
>
> Robert W Darr RNAC RAC-C
> Sunny View Care Center
> 410 NW Ash DR.
> Ankeny,IA 50021
> Office: (515)964-1101
> Fax: (515)965-1935
> Home: (515) 462-9138
> [EMAIL PROTECTED]
> [EMAIL PROTECTED]
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The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
         questions posted to NAC News and FAQs.
    For more info visit us at http://www.aanac.org
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