Fwd: Restorative as a stand alone skilled service

[Ldawja]

From the new online Benefit Policy Manual, Chapter 8 - Coverage of Extended Care (SNF) Services Under Hospital Insurance found at, 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 âdaily basis,â 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 âdaily basisâ 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 âdailyâ requirement would not be met.) This requirement should not be applied so strictly that it would not be met merely because there is an isolated break of a day or two during which no skilled rehabilitation services are furnished and discharge from the facility would not be practical. EXAMPLE A patient who normally requires skilled rehabilitation services on a daily basis may exhibit extreme fatigue, which results in suspending therapy sessions for a day or two. Coverage may continue for these days since discharge in such a case would not be practical. In instances when a patient requires a skilled restorative nursing program to positively impact his functional well-being, the expectation is that the program be rendered at least six days a week. (Note that when a patientâs skilled status is based on a restorative program, medical evidence must exist to justify the services. In most instances, it is expected that duration of a skilled restorative program last only a couple of weeks)."   -------------- In a message dated 3/2/2004 6:39:22 PM Eastern Standard Time, [EMAIL PROTECTED] writes:   Rena and Group--Recently there was information on the site regarding restorative as a stand alone skilled service--I misplaced that information.  Could you please re-send it?  Thanks so much!  Susan   Susan Hickson-Painter, R.N. MDS SUPERVISOR FRIENDSHIP HCC ROANOKE, VIRGINIA