1. If a resident who is on Medicare A is discharged to the hospital,
you need to restart his PPS cycle when he returns. The first assessment
after return would be a Medicare readmission/return assessment AA8b=5.
2.if you have a resident with available Medicare A days, you can cover him
on Medicare for daily IV antibiotics as long as he is receiving IV antibiotics
and has skilled days available.
3.You code a PPS 14 day as 0-7 unless it is combined with the admission
assessment. The code of 1 in AA8a= admission assessment. The
admission assessment is a required OBRA assessment within 14 days of
admission to the facility. If a long-term resident goes to the hospital,
is readmitted after discharge with return anticipated, there is no need to do
another admission assessment for Medicare purposes.
----- Original Message -----
Sent: Thursday, May 06, 2004 5:08
PM
Subject: Med A questions
Hi everyone:
I have taken over PPS at our facility, and am still struggling with a few
things. Can anyone help me with the following scenarios?
1) A resident is admitted to our facility with Med A coverage for
Rehab. Her 5 day MDS is completed, and 14 day is scheduled. She
goes out to the hospital two days before the ARD, and returns to the facility
the day before the ARD of the 14 day assessment. She was coded as an 08
on the D/C tracking form......discharged prior to initial assessment
completed. She was not on a bedhold. My question is: Do I
need to start the PPS process all over again with a 5 and 14 day? Or can
I do a re entry tracking form and complete the 14 day as scheduled, with the
scheduled care plan meeting? Also, if we do another 5 day, is it coded
as a return assessment? Either way, I know she needs to have a
comprehensive assessment, but I wasn't sure if I could use the one scheduled,
or if the process starts again.
2) Facility has bedhold in place. A resident who has been
unskilled for at least three months goes out to the hospital for behavioral
issues two weeks after his OBRA annual assessment is completed. Can we
pick him up for Med A based on the three day hospital stay/IV medication given
for at least five days?
3) Third question: When would you code a 14 day MDS 0-7
rather than 1-7? Is it when they were discharged after their initial
assessment was complete?
Appreciate any and all answers!
Thanks,
Donna
