I thought that when resident returned from hospital from 3 day hospital stay there was
a "presumption of coverage" and that you had to have a pretty darned good reason for
not admitting Medicare. If you skill for observation (after all she had to be in the
hospital for something) then if you set ARD for day 5 Med A coverage would apply thru
day 5. We were told at legal seminar that presumtion of coverage was really important
-- that if person has Part A benefits that we (SNF) were generally not entitled to
presume to take that benefit away. I'm paraphrasing, but I guess you get drift.
>
> From: "Angie Palac" <[EMAIL PROTECTED]>
> Date: 2004/03/03 Wed AM 06:54:30 EST
> To: <[EMAIL PROTECTED]>
> Subject: RE: Medicare Eligible
>
> Resident was treated for anemia and had a blood transfusion which would
> skill her for at least 5 days. MDS coordinator asked me if per chance
> the resident did not have anything to skill her in the hospital and she
> was not appropriate for therapy, how would the facility bill for the
> days she was in a Medicare bed until the evaluation was done and
> determined she was not Medicare eligible (admit Friday and eval on
> Monday). I don't know if this scenario ever happens. It seems to me
> that the report from the hospital would determine if she was eligible or
> not, and if not, do not put her in a Med A bed.
>
> Thanks, Angie
>
> -----Original Message-----
> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of
> claudia farrell
> Sent: Wednesday, March 03, 2004 5:21 AM
> To: [EMAIL PROTECTED]
> Subject: RE: Medicare Eligible
>
> Did the patient have IV's in the hospital? what were they tx for first.
> claudia farrell rn
>
>
>
> Claudia
> >From: "Angie Palac"
> >Reply-To: [EMAIL PROTECTED]
> >To:
> >Subject: Medicare Eligible
> >Date: Tue, 2 Mar 2004 21:31:48 -0600
> >
> >If a resident is admitted to a Nursing Home after a 3 day hospital
> stay,
> >and therapy was ordered, but unfortunately the resident was not
> >appropriate for therapy, what does the facility do? For example, the
> >evaluation was not done until Monday because the resident was admitted
> >late Friday. How does the facility bill for Friday, Saturday and
> Sunday,
> >and lets presume that there is nothing that the facility can capture
> >from the hospital. Has this ever happened to anyone? Any help would
> be
> >much appreciated.
> >
> >Angie
>
>
> _____
>
> Fast. <http://g.msn.com/8HMBENUS/2734??PS=> Reliable. Get MSN 9 Dial-up
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> /---------------------------------------------------------- The Case Mix
> Discussion Group is a free service of the American Association of Nurse
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> -----------------------------------------------------------/
>
>
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
