Ok Deb I am actually looking at the RAI manual and it says
on page 2-26 that if you discharge 08 and the resident is a medicare
return re admission then that is what you code. It also says the same if you
had done the admission assessment requirement and they are returning medicare
after an 07 discharge, you again code 5 in AA8b. It states
the difference between 1 and 5 in this instance is if they are
starting a medicare stay you will code 1 and if you are continuing a medicare
stay you code 5. This is what I said this morning but here is the source
documentation (in the RAI manual) on how to proceed. Do I think it is the end
of the world if someone re codes AA8b = 1 inappropriately - NO, but
there is a difference. Again I hope this
helps. Jeanne
Hi Jeanne,
I am no longer with the facility as I moved out
of state. However, I will be going back in the next weeks to help out
as the person that I trained quit!
Soooo....I got a call last night with the
scenerio I presented. I will attempt to take it further ...and perhaps
an easier read.
* Resident was on qualified
MC stay at the facility.
* Resident soured, sent out to the
hospital.
Facility completed a 5 day assessment
0/1 ( I think) or 1/1,
* Facility completed a return anticipated the
day the resident was sent out.
* Two days later Resident returned and facility
completed re-entry assessment.
* The question is do they complete 0/5 - Return
Assessement?
or
* Can another 0/1 or if not completed 1/1
initial be completed?
* It boils down to is a 0/5 assessment mandated
or can another 5 day assessment 0/1 be completed?
I gave them my answer and I told them what I
have done since the inception of PPS but I want additional
feedback.
The Nose
----- Original Message -----
Sent: Wednesday, December 03, 2003
5:50 AM
Subject: Re: Quick question for the
group-return assessment
Hi Deb, I am a bit confused by your question. If they d/cd prior to
initial why was a return anticipated discharge and re-enty
completed. When this resident returned they only needed coding
of 1 filled in for AA8a. A re-enty form would not be needed. Ok
now for the second part of your question. If they went out Medicare and
you had completed a PPS assessment for payment only purposes for the few
days they were in the facility then when they returned you would code a
1/5 but if they weren't on Medicare when they went out but had a 3 day
qualifying stay within 30 days you would code a 1/1 if you were picking
them up. If they haven't had a 3 day stay as I stated and don't have
a daily skilled service then you would only complete AA8a as a 1
and nothing in AA8b. The RAI manual is actually the best source for this
question but if your want the info about the 3 day stay you can find
it in the new manuals on the cms site. I don't have an actual page
for you because the manual set up is changed but they are actually
arranged nicely to find sources. Hope this helps.
Jeanne.
To the group....
Can a resident that has been D/C'd (prior
to initial assessment) to the hospital with a return anticipated
completed and re-entry completed after the 2 day hospital
stay....begin with a 5-day assessment
once again or must it only be a return assessment...or will either one
due.
Other than the RAI Manual... please
provide regulation sites.
The Nose
