Re: wellness period- PLEASE HELP....

[Alice Smith]

Title: Citrus Punch

http://www.cms.hhs.gov/manuals/102_policy/bp102c08.pdf 30.6 - Daily Skilled Services Defined (Rev. 1, 10-01-03) A3-3132.5, SNF-214.5 Skilled nursing services or skilled rehabilitation services (or a combination of these services) must be needed and provided on a "daily basis," i.e., on essentially a seven days a week basis. A patient whose inpatient stay is based solely on the need for skilled rehabilitation services would meet the "daily basis" requirement when they need and receive those services on at least five days a week. (If therapy services are provided less than five days a week, though, the "daily" requirement would not be met.) ----- Original Message ----- From: Jamie Morris, RN To: [EMAIL PROTECTED] Sent: Tuesday, February 17, 2004 11:15 AM Subject: Re: wellness period- PLEASE HELP.... Anyone have any other thoughts or references to back this up? ----- Original Message ----- From: Corey Ali To: [EMAIL PROTECTED] Sent: Monday, February 16, 2004 4:28 PM Subject: Re: wellness period- PLEASE HELP.... To the best of my knowledge, he would have no medicare days available, becaise at time he left, he was receiving skilled therapy, provided by a skilled therapist (just as the tube fed patient was receiving a skilled service) 5 days a week, which is the standard for the medicare Part A patient.  Your pt. receiving 5 days a week of therapy, rather than 3 days a week, would need to have a 60 day period of no skilled services to earn another Medicare benefit period. ----- Original Message ----- From: Jamie Morris, RN To: [EMAIL PROTECTED] Sent: Monday, February 16, 2004 3:52 PM Subject: wellness period- PLEASE HELP....   Does anyone have a reference to the specific place in a manual where it says ther. 5x/week interferes with a wellness period?  We are having this discussion at my facility & we have different info./opinions on this.  Therapy would like to have "written proof" that a Part B resident on therapy 5x/week is in a skilled stay.  We agree that a tube feeder is in a skilled stay even under part B, but we are not agreeing about the therapy. We have a part B resident that fell & began receiving PT 5x/week for ambulation..... I believe this interrupted his "period of wellness"... is this correct?  If he went out to the hospital & had a 3 day qualifying stay, when he returned, how much MCR would he have?  How would I know?   --- Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com). Version: 6.0.588 / Virus Database: 372 - Release Date: 2/13/2004