initial physician certifications for skilled residents

Specialties Geriatric

Published

My facility just became a dually certified facility for ICF/SNF. I am the medicare manager and am in charge of setting the ARDs for these elders, reviewing our documentation, ensuring our certifications are received in a timely manner. I am having difficulty with physicians signing the initial certifications on date of skilled admission. I originally started taking the forms to the Drs offices and picking them up on same date but this took time away from other work I needed to do as I am also the Restorative RN. I am now faxing the form and I faxed one on a friday, received it on monday with dr signing monday's date. I called to see if she could change it but she stated that if she has to date and sign it she will sign it for that date, but if it is already dated she will sign it. Our nursing consultant informed us that the doctor needs to sign, date and time the initial certification. We are hopefully going to be getting a computerized system so physicians can then do e-signatures, but right now we are using the paper process. Does anyone have a suggestion or idea or a solution on how you handled this problem with your physicians, if you did have the same problem? Thank you!

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Specializes in ED, Long-term care, MDS, doctor's office.

I have them sign the initial certification and the "before the 14th day" re-certification when the physician makes the first visit, which is usually within the first week of the patient's admission.

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do they sign for the admission date? I wish we had the luck of all of them coming within first week.

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Specializes in ED, Long-term care, MDS, doctor's office.

No. They just sign the day they are there. No back dating allowed. You may need to talk to the house physician to get him or her on board with a system to come in sooner, since this is new for your facility. If not, you may be out of compliance.

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We have them sign at Medicare/UR meeting, and we date them, MD signs, usually for the day of the medicare meeting which is weekly. They can pre-sgn and the first one can come from the Hospital MD ("this patient is certified to need skilled nursing...." look on the discharge papers, that cert covers for thefirst 14 days.

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so, you date them where the physician is supposed to date and time?

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