In Minnesota, with our case mix determined by another RUGs type system, there was much discussion about doing some kind of a comprehensive assessment say 1 month after hospital discharge. People were getting stuck with a high case mix RUG for 6 months because they had an IV in the hospital and never technically met the criteria for a significant change. At this point things are still this way. Makes it nice for the facility from a monetary standpoint, but not so nice if you're the one paying the bills or trying to explain the reasoning to an irate family member. I'm thinking this will be one of the changes in the future.
Jeana ----- Original Message ----- From: "carol maher" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Saturday, May 01, 2004 10:58 PM Subject: Re: 14 day > If your resident is Medicare A and is being covered only for the presumption > of coverage, the presumption of coverage only applies through the ARD of the > 5 day assessment. If at the ARD of the 5-day assessment you decide that > there is no daily skilled services, that would be the resident's last day of > Medicare coverage. Although the 5 day PPS assessment pays for days 1-14, it > only pays through day 14 IF the resident requires skilled services for the > entire 14 day period. > I was confused by your statement about doing a significant change to get a > lower RUG at day 6. That doesn't make any sense to me. If the resident > does not require skilled services and has had a 5 day done, doing another > assessment on day 6 doesn't make sense to me, so I am probably not > understanding your question. Also, with a new admission, a Significant > change cannot be done before the admission assessment is done. If you > combine the admission assessment with the 5-day, you would only need to do a > Significant change assessment if the resident met the qualifications for > significant change as outlined in the manual. > ----- Original Message ----- > From: "Julie Thomas" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Friday, April 30, 2004 1:53 PM > Subject: 14 day > > > > If you do a 5 day that sets your level of care for 14 days you cannot > claim > > the entire fourteen days if the resident's needs do not remain skilled for > > 14 days, right? Another words, you might have 14 days certified but if the > > resident no longer requires skilled services after 6 then you discharge or > > do a Sig change for a reduced RUG? > > > > Julie Thomas, RN BSN > > Quality/Clinical Coordinator > > KB Enterprises > > 254-445-2517 ext.16 > > > > This message is confidential, intended only for the named recipient(s) and > > may contain information that is privileged or exempt from disclosure under > > applicable law. If this message contains protected health information > (PHI), > > it should not be forwarded to any other recipient without the > authorization > > of the original sender and should be encrypted when possible. If you are > not > > the intended recipient(s), you are notified that the dissemination, > > distribution or copying of this message is strictly prohibited. If you > > receive this message in error, or are not the named recipient(s), please > > notify the sender at either the email address or telephone number above > and > > delete this email from your computer. > > > > > > > > --- > > Outgoing mail is certified Virus Free. > > Checked by AVG anti-virus system (http://www.grisoft.com). > > Version: 6.0.672 / Virus Database: 434 - Release Date: 4/28/04 > > > > /---------------------------------------------------------- > > The Case Mix Discussion Group is a free service of the > > American Association of Nurse Assessment Coordinators > > "Committed to the Assessment Professional" > > Be sure to visit the AANAC website. Accurate answers to your > > questions posted to NAC News and FAQs. > > For more info visit us at http://www.aanac.org > > -----------------------------------------------------------/ > > /---------------------------------------------------------- > The Case Mix Discussion Group is a free service of the > American Association of Nurse Assessment Coordinators > "Committed to the Assessment Professional" > Be sure to visit the AANAC website. Accurate answers to your > questions posted to NAC News and FAQs. > For more info visit us at http://www.aanac.org > -----------------------------------------------------------/ /---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/
