Federal Register/ Vol. 64,No. 146 on page 41658
For example, if the beneficiary is due for his 30-day assessment on
March 30 (day 30 of his Medicare covered stay), but he spends midnight
of March 27 in the ER, day 30 of his Medicare Part A covered stay now
falls on March 31, as March 27 does not count as one of the
beneficiary's 100 days of Medicare SNF care. In other words, the count
of days in the Medicare covered stay changes when there is a noncovered
day because the facility cannot count that day as one of the
beneficiary's benefit days.
If however the LOA day is during the observation period you don't change that particular observation period per the RAI excerpt below.
[EMAIL PROTECTED] wrote:
Holly, I don't believe your response was accurate. I have always understood that the Medicare midnight rule only affects billing, but it does not affect the assessment window or schedule. The discharge tracking criteria, page 2-26, affect the assessment window and schedule. Or am I missing some information?
Peggy E. Williams, SW, Public Health Advisor
Department of Health
Office of Health Care Facilities
Licensure and Certification
605-773-3356
-----Original Message-----
From: Holly Sox, RN, RAC-C [mailto:[EMAIL PROTECTED]
Sent: Tuesday, December 02, 2003 10:13 AM
To: [EMAIL PROTECTED]
Subject: Re: LOA - ARD window
According to the Midnight Rule, though, if the resident is not in the bed at midnight, then the whole day is disregarded, and your assessment window (and medicare calendar) is adjusted by one day. In your example, the assessment window would change to 11/20, if the resident was out of the bed at midnight.
Holly F. Sox, RN, RAC-C
Clinical Editor, Careplans.com
www.careplans.com [EMAIL PROTECTED]----- Original Message -----
From: MDS Lady
Sent: Tuesday, December 02, 2003 10:11 AM
Subject: Re: LOA - ARD window
Thanks...but the LOA was not during the observation period....
Caralyn Davis <[EMAIL PROTECTED]> wrote:Is this what you are looking for:
RAI User's Manual, Chapter 2, page 38:
Resident Leaves the Facility and Returns During the Middle of an ARD Period
The ARD is not altered if the beneficiary is out of the facility for a temporary leave of absence during part of the observation period. In this case, the facility may include services furnished during the beneficiary 's temporary absence (when permitted under MDS coding guidelines -see Chapter 3) but may not extend the observation period.
----- Original Message -----
From: MDS Lady
Sent: Tuesday, December 02, 2003 7:46 AM
Subject: LOA - ARD window
When a Medicare resident has an LOA day......is the ARD window adjusted?
Ex.: 60 day window 11/19 - 12/3, resident has LOA on day on 11/15. Does the 60 day window remain the same or change to 11/20 - 12/4?
Please include documentation.
Thx in advance!
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