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If she
is going to recieve any type of Rehab thru the 16th, then she would not need an
OMRA. Remember an OMRA is required when ALL therapy has been D/c'd and resident
remains on Medicare. If she has nothing to skill her ( ?any type of nursing
observation, etc...) then she would not remain on Medicare. Thus, PPS
assessments would stop. When she becomes weight bearing again and is picked up
by Rehab, she would need a Return/Readmit to Medicare
Assessment. Remember to continue the OBRA assessment
schedule
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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