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We are a sub
acute attached to an acute care hospital. So our pts go to another level
of care when they leave us. But we have a very wealthy pt who will be Non
Weight Bearing for 6 more weeks. She is reaching custodial care projected
as of the 16th. So we will issue a denial letter as of that date and she
will pay our very high daily rate to stay til she is able to have the external
fixator removed from her leg and then go back on Rehab to learn to walk
again.
My
question is this: I guess I need to do an OMRA MDS with an effective
date as of the 16th, but it will probably put her in a billable RUG even
though we have determined that there will be no skilled need. How do I do
this? Do I do an MDS and not generate a RUG code? Or do I not do an
MDS? Do I send an MDS? When I put her back on Medicare do I do a 5
day MDS? and then a 14? Or do I do something else? The only time we had a
similar situation the pt went to a relatives for care and then came back.
So it was a DC then a readmit to Medicare with a 5 day. I know LTC
facilities do this frequently so I need one of you to tell me what to
do.
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