Mds/pps Q&a 001

Tex...

I don't think you got the scenario right.

There is only one hosp'n involved. The resident, on return, was Medicare covered for 14 days for a skilled need (s/p Pneumonia) which was subsequently discontinued. There was no Rehab rx required initially since the resident was obviously physically able until 2/17 when staff noticed a decline.

The issue is how to capture the new RUGs which will be Rehab.

Don't worry 'bout the care plans and paper works.

You do an OMRA after d/c from Rehab if there is a skilled nursing need.

You don't need an OMRA after d/c from skilled nursing UNLESS there is a significant change. In this case an artrhitic "flare-up" is not a valid reason for a significant change, moreso if recovery is favorable in just 2 weeks of PT (as defined in RAI manual p2-8). Otherwise, you may need to do another SCSA in 2 weeks when the condition improves.

The 30-day would apply if the lapse in assessment would be more than 5 days of the grace period allowed of the next PPS assm't. In which case, restarting the 5-day is no problem.

In this scenario, wherein change in RUGs occured within the ARD window of the 14-day incldg. the grace days, the most logical reason is to restart the 5-day Medicare since you can use the projected dates of therapy, even tho P1b will only capture 1 day of rx.

However, would you consider an arthritic flare-up related to pneumonia (the actual reason for skilled need) even tho the incident appeared more than 2 weeks after hosp return?

Thanks for all the replies.