RE: Tubefeeders

[Faye Jones]

Just a comment.  Through my years of nursing in various venues, there have been repeated situations where the FI “interpretation” of a guideline resulted in denials etc and yet on appeal the facility was correct.  I would not change any of my thinking or functioning based on the “interpretation” of a representative of a fiscal intermediary unless they can give the source document.  As I have read the may e-mails r/t this topic I keep thinking that the phrase “can be done by a lay person after a reasonable period of instruction and therefore loses its skilled connotation with time” is a concept of home health care.  After all in a home health situation they are not going to pay for daily care indefinitely as that would not be the reasonable venue.  The expectation would be that that patient would need to be admitted to a facility for that level of care. I keep wondering if someone has inadvertently tried to apply the same reasoning to SNF care which is inappropriate.  Of course, who knows what “they” think at times.  I would proceed on the cautious side.  Who wants to be returning 100 days of reimbursement to the government? Ouch.   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of [EMAIL PROTECTED] Sent: Wednesday, November 26, 2003 8:26 AM To: [EMAIL PROTECTED] Subject: Re: Tubefeeders   In a message dated 11/26/2003 6:46:00 AM Eastern Standard Time, [EMAIL PROTECTED] writes: ask Sherry Kennedy to show you where the SNF manual was changed, regarding ending a benefit period.  I agree with Holly on this one. In ALL my training from the FI, once a resident reaches a skilled level and stays at a skilled level exhausting all Part A benefits, there are no more Part A days. Part B may be different, but Not Part A.