2 more assessment/coding questions please

i do disch return anticipated when she left.... entry tracking when she returns... and then just continue with next quarterly as scheduled ? is this correct ?

1. assuming no skilled service is required on return, that is correct. a "no sig. change status" determination can be recorded anywhere in the medical record, usually in the nurses' notes. the determination should be agreed upon by the idt.

2. the resident cannot be discharged if he/she explicitly went out for a family affair and failed to return to facility before midnight. this should be treated as a therapeutic leave of absence. on return, facility will adjust billing for a no payment on day of absence. your 90-day ard will also be moved by 1 day (that is, if ard is between day 80-94, it is now day 81-95 on return). see additional info next post ('can't seem to have the entire post together)

3. a discharge mds is required since death occurred outside of facility.

im ready to leave and get otice of same resident returning from home now to admitted icf/ltc non skilled......

why is resident treated a readmission as non-skilled? this is what cms says...

the "practical matter" criterion should never be interpreted so strictly that it results in the automatic denial of coverage for patients who have been meeting all of the snf level of care requirements, but who have occasion to be away from the snf for a brief period of time. while most beneficiaries requiring a snf level of care find that they are unable to leave the facility, the fact that a patient is granted an outside pass or short leave of absence for the purpose of attending a special religious service, holiday meal, family occasion, going on a car ride, or for a trial visit home, is not, by itself evidence that the individual no longer needs to be in a snf for the receipt of required skilled care.

http://www.cms.gov/manuals/downloads/bp102c08.pdf p35