Part Two of a two-part interview. I am completing a Discharge Assessment for a resident who, upon admission, had two stage 2 pressure ulcers
Question:
I am completing a Discharge Assessment for a resident who, upon admission, had two stage 2 pressure ulcers. How would I code Section M if one of the stage 2 pressure ulcers has healed and one has progressed to a stage 3 upon discharge?
Answer:
You would code just the stage 3 (code to the highest stage at the end of the look-back period) and it would not be coded as “upon admission”. That section is greyed out because this is a Discharge Assessment.
Question:
We have a resident who admitted and discharged to home on the same day. Do we get paid for any of those services we provided that day and what MDSs should we complete for that day?
Answer:
No, the facility does not get paid for the day of discharge even though it is also the day of admission. You would complete an Entry and a Discharge because those are tracking forms.
Question:
We have a resident who came into our facility on a Medicare Part A stay on 6/4/21. I set the ARD for 6/9/21. On6/8/21 she went to the hospital and returned on 6/10/21. Would this be considered an interrupted stay? Do I need to do anything else besides the OBRA Discharge?
Answer:
Yes, this would be considered an interrupted stay. A0310G1 would be coded yes, A0310H would be coded no, andA2400C would be dashed because Medicare is ongoing with an interrupted stay. Also, the ARD cannot be a leave of absence (LOA) day so you will need to change it since 6/9/21 is a LOA day.
Question:
I completed an OBRA Annual Assessment for a resident at the end of May and coded a pressure ulcer under Section M. Now I am completing a Significant Change in Status and discovered there was no pressure ulcer because it was just a shearing of the skin. What should I do to correct this?
Answer:
You should modify the Annual to take the pressure ulcer off the MDS.
Question:
We have a resident who admitted on a Medicare Part A skilled stay on 4/3/21 then discharged on 5/23/21. They want to readmit today 6/14/21. Can they be readmitted under a Medicare Part A stay without another 3-day qualifying stay and continue to use the days they have left?
Answer:
Since they are within the 30-day transfer period, they can use the remainder of their Medicare Part A days they have left as long as they meet the Medicare Part A post-acute care requirements.
