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The resident exhausted Med A benefits
(100 days). Level of Care was changed to ICF, thus starting the "days of
wellness" period. Resident would need to have 60 Uninterputed days of wellness.
Since PT 5x week is a Sklilled service the "days of wellness" period was
interupted and would start over once PT was d'c'd. Thus, resident's
hospital admission of 3 days for pneumonia dosen't requalify her for a new
benefit period. However, if PT had only seen her 3x week she would qualify if it
had been 60 days since last covered M''care day.
Hi
I hope this
is clear, it is goes. When a resident was part A and exhausted there 100
day benefit period and MD writes order for LOC to ICF this
then starts a pending new part A for this resident if he / she has a 60 day
wellness period , right ? BUT "then say 34 or
more days
go bye and this resident is experiencing freq falls and PT picks up
resident for pt tx 5 / wk x 2
weeks. Resident then reaches
max pot. pt d/c. Several weeks later after physicial therapy tx go
bye , resident became ill with PN hosp for 3 midnite stays ,
returns to the facility one and half weeks later. Is this resident qualified
once again for a new one hundred days of MCR services, or not , being
that the resident did not have a 60 day wellness period due to PT
part b tx right before hosp.
Please
respond, and if there is literature stated this please guide or email it to
me.
I guess what I am
trying to say is , Does Part B services OF any kind of therapies 5
times and / or skilled nrsg serivces like two stage 2's , one 3 or
4 with daily treat interrupt a resident's wellness period or not
?
nancy
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