Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]
Subj: Medicare inappropriate therapy
Date: 2/9/2004 6:30:46 PM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
I have a question for Rena Shephard. I have a resident who is 53 years old - victim of Baycol.. This man is extremely debilitated with extremely little hope for any functional improvement. After a court settlement the family receives $66,000 a month for his call and naturallly they want everything done for him. He is now private pay. Recently he had a 3 day qualifying stay in the hospital for a J Tube reinsertion. He now qualifies for medicare. Without the therapy minutes he would probably RUG at SE3 . The family insists on 3 hours of therapy a day which would RUG him at RUC but he doesn't qualify for skilled therapy. Medicare intermediary said we could bill medicare for nursing and bill for therapy minutes privately. My question is - do you leave the therapy minutes off the MDS or would it be better to have the family sign a medicare waiver? Please help with this as soon as possible.
Linnea - North Carolina
