Hi went through this last year in Louisiana.  The level of cares still have
to be tracked within a faciliklty.  It is medicare fraud to give someone 100
days who have not had the break in spell of illness or have gone from the
skilled level to ICF level of care in the 60 days.  I had this question at
the beginning of 2003 and there is some bill that the businees office sends
out to medicare that keeps track of this or something like this.  We had
residents when looked into medicar site that their days reset to 100 but we
knew that they shouldn't so we didn't skill them.  I am sure someone else
will reply with all the right information and correct way of going about
tracking.
Dawn Sheppard, RN, CRNAC
----- Original Message ----- 
From: "Debbie Settle" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Tuesday, January 13, 2004 3:36 PM
Subject: LEVELS OF CARE


> 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
> -----------------------------------------------------------/

/----------------------------------------------------------
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
-----------------------------------------------------------/

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