That is not correct
although many facilites choose to operate that way.
This is from the Medicare SNF Manual (Pub 12) at
http://cms.hhs.gov/manuals/12_snf/sn201.asp#_1_23
COVERAGE OF SERVICES 214.7
"Do not interpret the "practical matter" criterion so strictly that it results in the automatic denial of coverage for patients who have been meeting all of the SNF level of care requirements but who have occasion to be away from the SNF for a brief period of time. While most beneficiaries requiring an SNF level of care find that they are unable to leave the facility for even the briefest of time, the fact that a patient is granted an outside pass, or short leave of absence, for the purpose of attending a special religious service, holiday meal or family occasion, for going on a ride or for a trial visit home, is not by itself evidence that the individual no longer needs to be in a SNF to receive required skilled care. Very often special arrangements, not feasible on a daily basis, have had to be made to allow for absence from the facility. Where frequent or prolonged periods away from the SNF become possible, however, then questions as to whether the patient's care can, as a practical matter, only be furnished on an inpatient basis in an SNF may be raised. Base decisions in these cases on information reflecting the care needed and received by the patient while in the SNF and on the arrangements needed for the provision, if any, of this care during any absences. (See �242.3 for counting inpatient days during a leave of absence.)"
COVERAGE OF SERVICES 214.7
"Do not interpret the "practical matter" criterion so strictly that it results in the automatic denial of coverage for patients who have been meeting all of the SNF level of care requirements but who have occasion to be away from the SNF for a brief period of time. While most beneficiaries requiring an SNF level of care find that they are unable to leave the facility for even the briefest of time, the fact that a patient is granted an outside pass, or short leave of absence, for the purpose of attending a special religious service, holiday meal or family occasion, for going on a ride or for a trial visit home, is not by itself evidence that the individual no longer needs to be in a SNF to receive required skilled care. Very often special arrangements, not feasible on a daily basis, have had to be made to allow for absence from the facility. Where frequent or prolonged periods away from the SNF become possible, however, then questions as to whether the patient's care can, as a practical matter, only be furnished on an inpatient basis in an SNF may be raised. Base decisions in these cases on information reflecting the care needed and received by the patient while in the SNF and on the arrangements needed for the provision, if any, of this care during any absences. (See �242.3 for counting inpatient days during a leave of absence.)"
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of betty haines
Sent: Monday, December 01, 2003 12:21 PM
To: [EMAIL PROTECTED]
Subject: Re: therapeutic leave of absence/MEDICAREMy understanding is- if they're not in their bed at midnight, they are discharged.
[EMAIL PROTECTED] wrote:Can someone pls tell me what to do when a Medicare person went out on pass/therapeutic bedhold and they were out for 3-4 days (went home for Thanksgiving). Theyre both on PT?OT. Do I have to discharge them right away? Thank you.
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