Help.....
Admission Director accepted resident for respite care (daughter having
minor surgery) and told family she would qualify for Medicare A based
upon being within "30 day window". When she arrived late yesterday,
she had no paperwork from hospital, only list of meds, diet, routine,
etc. from daughter. Called MD and he faxed medications with order for
speech and PT.
Today, I asked admission director for some sort of "official paperwork"
from hospital or MD with regard to discharge date from hospital. Our PT
had referred her (she was a home pt of his) and he had informed the
admissions director she was in the "30 day" window. She took the
resident based on his info!
Hospital wouldn't provide info (HIPAA) and SNF has not provided us info
either. PT finally came up with a copy of admission face sheet his home
agency that indicated resident was discharged from hospital on 3/30,
admitted to another SNF on 3/30 , went home on 3/15 and was admitted to
us on 4/29.
If I calculate right, the first day of the "30 day window" from
hospital stay is 3/30; therefore, she was admitted to us on day 31. (29
days in April, 2 days in March). ST and PT were both evaluated and
treated today.
Informed family that according to our calculations and info provided, I
would need to issue a denial letter based on not having 3 day qualifying
stay while we attempt to get the days accurately.
Was this correct?
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