Forgotten Assessment

[ibtootie]

I have a Medicare patient that was admitted to our facility for 15 days. Although I usually combine the 14 day and discharge assessments in cases like this, I miscounted her days and submitted a discharge assessment and neglected the 14 day assessment. Can I submit the 14 day assessment late, or would it be better to submit a corrected combined assessment?

[rnman99]

If your resident was discharged on day 15, you're OK. If not... I'm not sure. If you submit a 14 day after the discharge then you get flagged for out of sequence. Maybe you could modify the d/c and add a 14 day...

[Talino]

The 5-day would have paid you ‘til day 14. So, I am assuming the resident was still in facility on day 15th and was discharged on day 16th. If this is the case –

You can submit a correction then combine a DC and 14-day. The ARD is DC day. The 14-day will pay you for 1 day, day 15th.

Was this a new admission? If so, an OBRA Admission MDS should have been completed also no later than day 14th. This you cannot create.

[andy3k]

If you perform a PPS assessment with an ARD earlier than the discharge date, but forget to enter it, then you can enter and submit it at any time (though it may be considered late).

If you perform a PPS with an ARD same as the discharge date, but forget to enter it, then you can modify/inactivate the discharge MDS to include the PPS (though it may be considered late).

RAI Manual pg 2-66:

Missed PPS Assessment

If the SNF fails to set the ARD prior to the end of the last day of the ARD window, including grace days, and the resident was already discharged from Medicare Part A when this is discovered, the provider cannot complete an assessment for SNF PPS purposes and the days cannot be billed to Part A. An existing OBRA assessment (except a stand-alone discharge assessment) in the QIES ASAP system when specific circumstances are met may be used to bill for some Part A days. See chapter 6, Section 6.8 for greater detail.

[ibtootie]

Yes, it was a new admission. Wow, there is so much more to MDS than anyone outside the business realizes. This certification needs to be more than just a few days. I'm still trying to wrap my head around it all, and still feel like I needed more instruction than I got.

[rukiddingme]

Believe that you aren't alone in the 'missed assessment' problem. We're finding discharges to be a definite pain, and have missed a couple of those. Of course by the time we find one that was missed/forgotten, it's too late, so the assessment ends up being late. Sometimes the workload is heavy, and we're just human, so we do make mistakes.