Re: Rena/part B medicare

[RRS2000]

If the rehab therapy under Part B rises to the level of a '"skilled level of care" - which would be a daily, medically necessary skilled service as defined under Part A - then it would interrupt the count toward the 60-day break in skilled services.  (It's the same concept that prevents the 60-day break from occurring for the resident who exhausts the 100 days because of a tube feeding but continues to receive the tube feeding in the facility at levels that meet the definition of skilled level of care.)

Since rehab services delivered 3 or 4 days per week do not rise to the level of a skilled level of care, those services do not interrupt the count toward the 60-day break.  When you get to 5 days per week, that is the definition of "daily" for skilled rehab services under Part A, and therefore those services, if medically necessary, constitute a skilled level of care that would interrupt the count toward the 60-day break.

Rena

Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]

Subj: Rena/part B medicare
Date: 4/3/04 5:39:45 AM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
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Rena,am I correct to think that medicare part B services,i.e. physical therapy 3-4 days is not a skilled service.Therefore, if a resident stays in facilty and accesses part B, it is not counted in our 60 day spell of wellness.I consider part B rehab as unskilled as it is same servive you could get at home in out patient setting.We always have orders under our part B rehab at 3-4 times a week because our rehab director considers 5-6 times a week for rehab under part A.