RE: LOA and Med A

Wed, 17 Dec 2003 13:54:01 -0800

Rena,

 

It is Medicaid that has the 18 therapeutic days-I just spoke to my financial counterpart who confirmed this (Michigan).  The reference to LOA days for Medicare A is the “Intermediary Manual Part 3 Chapter II-Coverage of Services” page 25 “Coverage of Services    3132.6”.  Here is the website for the material:  http://cms.hhs.gov/manuals/13_int/a3130.asp.  Sorry about the mislead related to the number of days.  It seems clear that a therapeutic reason would be indicated for frequent or prolonged use of LOA days.

 

 

 

Jane Craven, RN, C.

Sr. Consultant, Nursing Services

Tendercare (Michigan) Inc.

 

-----Original Message-----
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Subject: Re: LOA and Med A

 

"There are 18 therapeutic LOA days per year for Medicare A recipients.  They need to have a therapeutic purpose."

Can you please share the source of this information?

Thank you!

Rena


Subj: RE: LOA and Med A
Date: 12/17/03 11:51:39 AM Pacific Standard Time
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This is inaccurate.  The 24 hour rule applies to ability to bill (you
can't if they are not in the bed at midnight) and if the resident is out
of the building 24 hours or more, but expected to return, the MDS clock
for PPS purposes resets to a 5 day.  There are 18 therapeutic LOA days
per year for Medicare A recipients.  They need to have a therapeutic
purpose.

Jane Craven, RN, C.
Sr. Consultant, Nursing Services
Tendercare (Michigan) Inc.


-----Original Message-----
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Sent: Wednesday, December 17, 2003 9:58 AM
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Subject: Re: LOA and Med A

My understanding is "no," as they must be in the facility at midnight.
They may be "on leave" from 1201 a.m. until 1159 p.m., but they must be
in the facility at midnight.
                       Renie





Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
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