medicare cert sheets

Use the actual admit date even if MD comes in 2 or 3 days later to certify the need.

This is what the reg says...

40.2 - Certification for Extended Care Services (Rev. 1, 09-11-02)
The certification must clearly indicate that posthospital extended care services were required to be given on an inpatient basis because of the individual's need for skilled care on a continuing basis for any of the conditions for which he/she was receiving inpatient hospital services, including services of an emergency hospital (see Chapter 5, §20.2 prior to transfer to the SNF. Certifications must be obtained at the time of admission, or as soon thereafter as is reasonable and practicable. The routine admission procedure followed by a physician would not be sufficient certification of the necessity for posthospital extended care services for purposes of the program.

http://www.cms.hhs.gov/manuals/downloads/ge101c04.pdf p13