Hi Michelle.  Since she has never used Medicare days, the "60-day break"
rule doesn't apply.  Now that she has had a qualifying hospital stay and
returns to you with SNF orders and daily skilled interventions, you can
skill her.  Please have your business office manager check the Common
Working File to verify 100 days available.
I'm attaching the Spell of Illness/Benefit Period Decision Tree.  Please
review the first page for your situation.
Winona Phelps, RN



-----Original Message-----
From: Michelle Witges [mailto:[EMAIL PROTECTED] 
Sent: Tuesday, April 20, 2004 3:53 PM
To: [EMAIL PROTECTED]
Subject: skilling for old peg tube


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 

Attachment: benefit period.doc
Description: Binary data

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