I would guess that the utilization of rehab with the dx of pneumonia is being looked
at.The assumption was always that a patient would return to baseline once pneumonia
was ressolved without the need of skilled rehab.Some patients I believe do need a snf
admissiom with dx of pneumonia because they usually have other multiple diagnosis that
come into play.But do they need skilled rehab for an extended period of time[I know
this is a case by case determination]Remmember a dx of pneumonia is a Complex Rug
score but an extended rehab stay is a higher Rug.CMS is always looking at trends.My
facility does not keep patients on rehab for long periods of time,we don't have to as
we have multiple admissions with few empty beds,but I hear from many other places that
alot of the chains 'push the envelope as they say'with keeping patients on skilled 3-4
days after rehab stops for OBSERVATION.Those few days can over time and multiple
patients add up to alot of money.I have always practised that we look at each case,no
routine days for Observation
.I feel you always have a 30 day window to pick up again and besides most of my short
termers don't want to hang around 3-4 days after rehab concludes.As I have said before
CAN YOU SUBSTANTIATE YOUR CLAIM ON A MEDICAL REVIEW?If the answer is Yes,then you are
making the right decisions.
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