COT's

[Dharriott]

I need some clarification on COT's combined with a scheduled PPS assessment. I believe that it is ok if the RUG changes for a scheduled PPS assessment so why combine the scheduled PPS assessment with a COT?

[Talino]

It has to do w/ the start of the payment period.

If the COT ARD is Dec. 7, RUG payment of the COT begins on Dec. 1st (day 1 of COT) and will extend to the end of the payment period of the combined PPS assm't.

Assuming this was a stand alone 30-day PPS, RUG payment normally commences on day 31 until day 60. If the COT is combined w/ this 30-day, the RUG payment will commence earlier than the 31st, that is, from day 1 of the COT observation period up to day 60th.

see also the RAI p2-55

[andy3k]

RAI page 2-51: "Alternatively, the SNF may choose to combine the COT OMRA and scheduled assessment following the instructions discussed in Section 2.10."

If the COT RUG would pay higher than the RUG that preceded the scheduled assessment, combining the COT with the scheduled assessment would allow you to collect the higher RUG starting at the first day of COT observation period and all days following. Without the COT, you don't get the higher RUG rate until the scheduled assessment kicks in.

Alternatively, if the RUG is lower, you would NOT want to combine the COT and scheduled assessment because then the lower RUG would start paying from first day of COT observation period instead of when the scheduled assessment kicks in.

[andy3k]

I got ninja'ed by Talino.

[amoLucia]

I got ninja'ed by Talino..

I don't speak MDS either!!!!