EOT - resumption

Talino · Aug 2, 2017

Create an MDS EOT (not SOT) w/ ARD 7/23

Section O0450a = Yes

Section O0450b = 7/24

You will find this guide on p2-53 #3

MDSRN15 · Aug 3, 2017

It turned out, it will only be an RM.

How do I get paid for 5 days. See below.

14D --- 7/14 ARD - pays for 7/14 -- 7/20 - RVC20

EOT-R or EOT --- 7/23 ARD - 7/21 -- 7/23 - LD10A

SOT??? --- what ARD to pay for - 7/24 - 7/28 - what rug payment? --- rehab has an RM

End of PPS - 7/28

Talino · Aug 3, 2017

In your original post, you have mentioned that the resident will resume at same RUG level --

Experts,
same rug level when it ended

... that's the reason for the EOT-R.

But since your RUG level is not what it used to be, EOT-R will be incorrect as stated here...

3. In cases where therapy resumes after the EOT OMRA is performed and the resumption of therapy date is no more than 5 consecutive calendar days after the last day of therapy provided, and the therapy services have resumed at the same RUG-IV classification level, and with the same therapy plan of care that had been in effect prior to the EOT OMRA

Since your RUG level is not the same as the previous, you will need to do SOT as stated in p2-52...

2. In cases where therapy resumes after an EOT OMRA is performed and more than 5 consecutive calendar days have passed since the last day of therapy provided, or therapy services will not resume at the same RUG-IV therapy classification level that had been in effect prior to the EOT OMRA, an SOT OMRA is required to classify the resident back into a RUG-IV therapy group and a new therapy evaluation is required as well.

To emphasize, there must be a new therapy eval.

To summarize, you will need EOT ARD 7/23 and SOT ARD 7/24. Whatever the RUG level SOT calculates is what pays for 7/24 - 7/28.

MDSRN15 · Aug 3, 2017

Can I use 7/28 5th day for SOT-ARD? It says 5-7 days for the ARD.

It is also the end of PPS and she was seen that day.

Will it apply in the scenario?

Talino · Aug 3, 2017

Can I use 7/28 5th day for SOT-ARD? It says 5-7 days for the ARD.
It is also the end of PPS and she was seen that day.
Will it apply in the scenario?

7/28 is actually the correct ARD, not 7/24, my bad. But no, you cannot combine the PPS discharge. It has to be completed separately with same ARD.

MDSRN15 · Aug 4, 2017

Yes. It was 7/28 for an RMC pays for 7/24 - 7/28

THANK YOU VERY MUCH AGAIN!!!