Re: Leave of absence

[RRS2000]

No, it is not so.  When the Part A resident is out of the bed at midnight, the facility cannot charge for the preceding day.  However, that does not have any implications with regard to discharging the resident.  For a temporary leave of absence, it would not be appropriate to discharge the resident.  As I said earlier, the flowchart on page 2-26 spells out the discharge and reentry issues from an MDS perspective.

Rena

Subj: Re: Leave of absence
Date: 4/20/04 3:33:03 PM Pacific Standard Time
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Rena,
My DON and I have been following this conversation and we are just astounded. We have always been told at any seminar or training that we have taken,  that if a Medicare Part A resident was out of the building for any purpose at Midnight they must be discharged from the facility. Is this not so then?
Patty
Patty Beeken LPN MDS
Midlands Living Center
2452 North Broadway
Council Bluffs, IA 51503
712-323-7135

----- Original Message -----
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Sent: Tuesday, April 20, 2004 9:42 AM
Subject: Re: Leave of absence


I agree - this is the core of the issue. 

What did the physician's orders say - was it a discharge home?  If it was, a discharge tracking code of Discharged Return Not Anticipated and a new Admission assessment within 14 days of readmission would be required.  Also, if applicable, the PPS assessment would begin again with a new 5-day assessment. 

Or was it a visit home (or "out on pass") while still a resident of the facility?  In that case, no discharge or reentry tracking form is required, the OBRA schedule would pick up where it left off, and the PPS schedule would pick up where it left off, excluding the days out of the facility.  For details, see the flowchart on page 2-26 of the RAI User's Manual.

Rena

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