Re: NEED ADVICE ON WHAT TO DO

[Nathan Lake]

I think you will end up in trouble if you try and consider this resident skilled beyond 01/22 (01/12 + 10 days). Whether you have a D/C order or not, you have documentation that states the services were not provided after 1/12 and an OMRA should have been done within 10 days (assuming there are other reasons to skill the resident. Section P is days and minutes of therapy provided, not ordered. With an ARD of 2/17, section P reads all zeros.   Trying to lay out the time table I get the following   Day 21 - 34 (01/06 - 01/19) the 30 day assessment was due. Day 27 = 01/12  (Therapy stopped) Day 31 =  01/15 Day 50  =  02/04 Day 50 - 64 (02/04 - 02/18)  the 60 day is due Day 60 = 02/14 Day 63 - 02/17 (ARD for 60 day)   I don't think there is a good way out of this.   I am concerned about what was on the 30 day assessment . What was the ARD for that one and were the minutes on that assessment accurate? If not, you need to correct that assessment, and then correct the billing which I assume has already been submitted.   If the resident can not be skilled for reasons other than therapy,  you need to correct your billing to show him going off of Medicare on 01/12.   If the resident can be skilled based on non-therapy reasons, one alternative (one which has been discussed ad nauseum on the listserver and most people agree is not allowed), would be to do an OMRA with an ARD of 02/22, an R2b of 03/16,  and adjust your billing based on that. If it were me, I would do that. Even if it is not technically allowed, you are using it to correct an error and not to gain any benefit from it. I know of no other way to enter data into the system that will accurately reflect what happened.   Nathan         ----- Original Message ----- From: Edna Adam-Claros To: [EMAIL PROTECTED] Sent: Tuesday, March 16, 2004 1:08 PM Subject: NEED ADVICE ON WHAT TO DO MAYBE NATHAN CAN HELP US   SCENARIO: PT SKILLED FOR REHAB (ST/PT) AND GT. 60 DAY ARD: 02/17 60 DAY REFERENCE PERIOD : 02/04 -02/18 LAST MEDICARE COVERED DAY: 02/17   PT PROGRESS NOTES: D/C SKILLED SERVICES AS OF 01/12.  NO PHYSICIAN ORDER WAS OBTAINED/WRITTEN.   ST PROGRESS NOTES: "PT HAS BEEN D/C THIS PAST WEEK SECONDARY TO....".NO PHYSICIAN ORDER WAS OBTAINED OR WRITTEN.   REHAB DID NOT MENTION ON PPS MEETINGS THAT RESIDENT WILL BE OR HAS BEEN D/C'ED.   QUESTION: CAN RESIDENT STILL BE CONSIDERED SKILLED UNDER REHAB TIL LAST MCR COVERED DAY (2/17) BECAUSE THERE IS WRITTEN D/C ORDER?  OMRA WAS NEVER SCHEDULED SINCE THERE IS NO REHAB D/C ORDER.    signature Do you Yahoo!? Yahoo! Mail - More reliable, more storage, less spam