Re:

[RRS2000]

It is not necessary to transmit it to the state.  However, if the facility is Medicare and/or Medicaid certified, it is not prohibited, either.

Rena

Subj: RE: 
Date: 5/11/04 12:03:00 PM Pacific Standard Time
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Thank you again for the info.  I just checked our contract and yes we are supose be utilizing the RUG levels. I can recreate the assessment from the info in the chart, but do I send it to the state?  

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Sent: Tuesday, May 11, 2004 2:25 PM
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This is a different issue.

If your facility has a contract with an insurance company that utilizes RUG levels for payment, then it is the facility's responsibility to provide the RUG level.  Depending on what the contract actually says, since this case is not subject to Medicare PPS regulations, you may be able to go back and recreate a PPS assessment even though the assessment window has closed (and therefore it would not be permitted under SNF PPS).

Rena

Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
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Subj: RE: 
Date: 5/11/04 11:13:23 AM Pacific Standard Time
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That's what I thought............Thank you.  We have a resident that was here for nine days and was comm insured.  the insurance company wants a RUG rate and an MDS which we can not provide because I did not do one but did a d/c 08.  They are now trying to deny the claim. 

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Sent: Tuesday, May 11, 2004 2:01 PM
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An initial Admission Assessment is not required when a resident is discharged before the end of day 14.  The only requirement is the discharge tracking form with the code 8, discharged prior to completing initial assessment.

Rena

Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
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Subj: 
Date: 5/11/04 10:53:56 AM Pacific Standard Time
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HELP!!!


If there is a Commercially insured resident (not Medicare) that stays less than 14 days, do I need to do an admission MDS or can I just do a discharge prior to completion??
Thanks in advance!