From my understanding in N.C., everything is in motion to be either skilled or nursing home period. No one should ever keep anyone that doesn't qualifiy for nursing home anyway.We make sure these people have always been d/c to an assisted living, unless they are private pay. Medicaid is not putting out the money yet. You and I are going through the motions right now. For example, we really don't need to have UR anymore; Fl2's on what use to be ICF level;you have to transmit on the last day of q qtr to the state anyone that their rate is diffirent, a significant change/getting therapies etc; your long term tube feeds, stage IV's all of these different type of issues; will bring you a higher rates, instead of the ICF 1.00 a day & ICF skilled 1.29 a day(joking) on the money. Let me know if I am off base, but this is what I have been doing, and reviewing. Q thing I transmited to the state on the last day in sept of 03, was nerve racking because it is suppose to reflect new "prposed rates". No one in the facility is allowed
to recieve Med B therapy until it is reviewed and approved by myself, don, adon or if necessary our administrator. This has cut out about 90% of unnecessary therapy's.
Claudia >From: "Debbie Settle" <[EMAIL PROTECTED]> >Reply-To: [EMAIL PROTECTED] >To: <[EMAIL PROTECTED]> >Subject: LEVELS OF CARE >Date: Tue, 13 Jan 2004 16:36:14 -0500 > >I have a questiion that I've not seen addressed here yet. I am in NC where >we recently went Case-Mix on Medicaide. We no longer have "Skilled" or >"ICF" levels of care. We have "Nursing Home" and "Domicilary." If someone is >Domiciliary, we have to get them into a Rest Home or Assisted Living >Facility. However, my question is.... If we no longer have "SNF" level, how >do we determine if someone has had a 60 day period of wellness? Currently we >are allowing residents to have another 100 Med A days if they haven't been >in hospital in 60 days. I'm not comfortable with this, but I'm told it >dosen't matter since there are no more levels. Can someone shed some light >on this??? > >/---------------------------------------------------------- >The Case Mix Discussion Group is a free service of the > American Association of Nurse Assessment Coordinators > "Committed to the Assessment Professional" >Be sure to visit the AANAC website. Accurate answers to your > questions posted to NAC News and FAQs. > For more info visit us at http://www.aanac.org >-----------------------------------------------------------/
Find out everything you need to know about Las Vegas here for that getaway. /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
