|
If I was informed (or the floor nurses were informed) that the patient was
not coming back, I would wait until the return date and then do a discharge with
return expected, with the d/c date the day they left the facility. (We
have up to 7 days after the d/c to do the d/c.) Then, if they weren't back
in another week, I'd do another d/c w/o return expected to correct the d/c w/
return expected. Seems to me you'd do a correction of the D/C "assessment"
tracking form, but I was instructed by our consultant that we just did the
second d/c, with the original date they left the facility on it. The
office MAY NOT bill for days the patient isn't there unless there is a bed hold,
AND there is no knowledge that the patient isn't coming back. Certainly
billing bed hold days is fraud if there is documentation saying the patient
isn't returning. (And not documenting the patient's exit statement would
be held to be facility-directed fraud if the facility instructed the nurses to
not document what was said to them regarding their teaching prior to LOA.)
Corey
----- Original Message -----
Sent: Monday, December 01, 2003 1:27
AM
Subject: LOA and survey
I am also in Ohio and our survey just ended. Much
improvement over last year and we did really well with care and safety.
I just want to let others know that they originally showed up en masse at 3 pm
on a Monday. And they stayed 5 days. Fairly exhaustive
survey. I believe that when the final report comes back, we will have
done well, with just a few minor things. The only area of concern that I
have (and my co-workers) is the issue of LOA's and bedhold days becoming a
problem. Our facilty is urban and we have a lot of younger people with
medical/psychological problems who all want the privilege of coming and going
as they see fit. The DON was so afraid of census dropping, because these
people would threaten AMA if we didn't give them the LOA that she overroad our
own policy and would let them go. Many of them had let the staff know
they had no intentions of returning and this would get charted. So MDS
discharges them. But the admissions office kept them on the LOA list for
up to thirty days and those days were often billed for. Fraud is fraud
and no one would listen to the MDS nurses on this issue. And the DON is
acting like this is the first she has heard of it. It is so frustrating
and most of us don't know what to do. Our DON will do anything to cover
her own behind, including dumping off on others. Because this is a
serious issue, how do we handle it? From MDS point of view? Anyone
else ever run in to this problem?
|
