Combined admission and 5 day

Specialties MDS


An admission assessment was submitted combined with a 5 day assessment....come to find out the patient wasn't even Medicare. (Did not find out until after discharge) What do I need to do about the unnecessary 5 day assessment?


1,010 Posts

Specializes in ER CCU MICU SICU LTC/SNF.

Since you won't be billing Medicare, you don't need to do anything.


171 Posts

Why would you submit a 5 day with a comprehensive? Is that the policy of the place you work? Why didn't your software flag that, if not? Did you indicate the pay source was Med-A? If yes, you need to correct the glitches that have already been sent into the netherland 'bowels' of the MDS system- it will show up in the future, somewhere, and might impact another facility, etc. Contact your state MDS Coordinator if you have any questions. In this digital age, really- every keystroke and MDS submission can have unintended consequences.


171 Posts

Possibly, this is also a HIPPA violation. Even though the payer may have the right to receive MDS information that is legally required for payment and other protected reasons- the MDS you submitted was not legally required to be submitted for payment, hence- you offered personally identifiable information (other than an admit form) that was not supposed to be entered into the MDS realm. I'd ask about these things, as a matter of your routine. These privacy laws are not only becoming more convoluted, but the penalties for breaching them is also becoming way more serious.

Thanks for the replies...I appreciate.

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