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Discussion

Managed Care

Recent Resident admitted for a short stay following a knee replacement. She stayed for 10d with Priority Advantage as her payor source. My preceptor taught me that if a managed care Res is here less than 14d, we can change the admission assessment to a 5d. I changed the assessment type and am currently inputting my data. Questions:

Section GG - should I just select the "dashes" since this is a Med A requirement (at least at this time) only?

Section A0600B: Medicare number (or comparable railroad insurance number) is blank and is "red" indicating an error. Do I disregard this as well? I am in the process of learning the submission process, but from what I do understand, managed care assessments are not submitted?

My MDS preceptor/guru just retired so I am unable to bounce questions off her anymore. :-( I really appreciate all the help I have been given on this site. Thank you!!

off topic - Would asking my boss for a membership to AANAC be beneficial? When I google MDS questions, many of the results reference that website.

Thanks!

-Amy

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    Correct. MDS created for Managed Medicare entities are not transmitted. Section GG is not factored in the RUG calculation so you can dash-fill it. Ignore A0600B.

    Membership is beneficial, not only to you, but the entire facility who seek to comply with CMS regulations. Try a year's membership and share access to your QA/QM QAPI team.

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