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This is only accurate if the person has already
used a Medicare SNF benefit period. A beneficiary will not earn a new
benefit period unless s/he has the 60 day break in skilled services.
However, if a beneficiary has never used the benefit before, then there is no
requirement for a "60 day break" prior to using the Med A SNF days.
If this resident has been in your facility since
2000 and never used Medicare A, then you can certainly skill her now for the
tube feedings.
HS
----- Original Message -----
Sent: Tuesday, April 20, 2004 4:05
PM
Subject: RE: skilling for old peg
tube
You are right; you can not skill her
because no break in spell of illness. She has been receiving skilled
service for years for the peg tube regardless of never billing under med
A. Unless if she stops the PEG feeds for 60 days or she d/c to a
non-nursing care facility, she will never regenerate her 100 days. This
was a big question for me at the AANAC conference and this was the
conclusion, so I feel pretty confident in this advice.
monica
I have a situation regarding a resident. We admitted her from
home in 2000 to a non Medicare A bed. At time of admission she had a
PEG tube and eating oral diet. The amount of tube feeding did not meet
skilled criteria. She was supposed to be a respite stay for 2 weeks
but ended up staying. Anyway, she ended up with tube feeding for 100%
nutrition. She has been in facility since 2000 with no hospital
stay. She currently was d/c'd to hospital for pneumonia. My DON
thinks that we would be able to skill her for tube feeding as she never used
her Med A days after first inserted. I am inclined to think no since
she has not had a 60 break in spell of illness. What is right?
Thanks
Michelle
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