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Ahh, well then, ask Sherry Kennedy to show you
where the SNF manual was changed, regarding ending a benefit period. I
don't know if you saw my rant a few weeks ago about consultants, but that's one
of the things that keeps me from becoming one. There are too many things
that I still don't know, and so many consultants out there will tell you what
they think, rather than having factual information.
Trouble is, you can't always tell what type you are
getting until you have already paid the fee.
Holly
----- Original Message -----
Sent: Tuesday, November 25, 2003 7:54
PM
Subject: Re: Tubefeeders
I understand that and have always taught that. However,
Sherry Kennedy in TX and the BC/BS FL intermediary training this spring and
fall said that this has changed. I am just looking for it in
writing.
Thanks...cher
Holly Sox, RN, RAC-C wrote:
Cher,
No, No, No! If the resident remains at
Medicare skilled level of care, receiving skilled services, then the benefit
period does not end. Ever.
Holly
-----
Original Message -----
Sent:
Tuesday, November 25, 2003 9:13 AM
Subject:
Re: Tubefeeders
Yes, that is correct, but that is not the question I was
asking. If they stay in the facility as a full tube feeder, nothing
by mouth, I am being told by 2 facilities who went to Medicare Workshops
that these people can be re-skilled agin after they meet all the other
criteria. That's what I am wanting in writing. No one seems to
have answered that question yet.
Thanks...Cher
Callie Larson
wrote:
You are correct. The following is the answer posted on the
AANAC FAQ list on the website regarading this issue:
A. The period of time the beneficiary was receiving the tube
feeding at home does not constitute a skilled level of care for SNF Part
A purposes, even if she received skilled home health services under
Medicare. Only skilled level of care received in a SNF or a hospital
prolong the benefit period. So, if she was at home for 60 days, then she
did have the 60-day break in skilled services and would earn a whole new
100-day SNF benefit after a qualifying 3-day hospital stay.
This
is from the Medicare SNF Manual (Pub 12), Section 240:
I
always thought that if a person went home on tubefeedings they were at
a nonskilled level of care.Anytime the patient goes home the 60 day
clock
starts.
/----------------------------------------------------------
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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
-----------------------------------------------------------/
Caroline Larson, RN, MS, RAC-C
MDS/PRI Coordinator
Fairport Baptist Homes, Fairport, NY 14450
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