Skilled or not skilled per Medicaid guidelines has nothing to do with the Medicare skilling regulations. They can be ICF for Medicaid but still meet the MCR criteria for skilled....if skilled per MCR then no 60 day break.
Julie LaCroix <[EMAIL PROTECTED]> wrote:
Julie LaCroix <[EMAIL PROTECTED]> wrote:
Medicaid routinely authorizes a three month SNF benefit for GTF once Medicare is exhaused. After the three month period, unless there are complications, only ICF coverage is granted. Comments?----- Original Message -----From: [EMAIL PROTECTED]Sent: Friday, March 12, 2004 6:40 AMSubject: Re: Gastrostomy tubesThis is not correct. The regulations have not changed in a long time. Once benefits are exhausted, as long as the resident remains in the SNF (or a hospital) and continues to meet the criteria for Part A coverage, he will not have a 60-day break in skilled services and therefore will not be able to qualify for a new benefit period. Diagnosis is not a consideration.
See Benefit Periods at http://www.cms.hhs.gov/manuals/101_general/ge101c03.asp
Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]
-----Original Message-----
From: Tracy Howard [mailto:[EMAIL PROTECTED]
Sent: Friday, March 12, 2004 8:33 AM
To: [EMAIL PROTECTED]
Subject: Gastrostomy tubes
I was told yesterday that there was an update to Medicare a couple of years ago that stated that g-tube feeders who have used their 100 days for their g-tube, can be reskilled for something else such as an infection or wound later on after 60 days and had a 3 day qualifying stay, but can never be skilled for their g-tube again. Is this correct? Does anyone have any references to this?
Tracy Howard, RN, BSN
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