? regarding SC

[Sheryl218]

Hi, we had a pt return from the hospital on 9-1 now on hospice. She passed away on the 4th. Would the ARD be 9-3 or 9-4? Would the CAA's have to be completed? Thanks much, Sheryl

[Bella'sMyBaby]

Did she die in your facility? If so, code the MDS "Death in Facility" this will be a tracking MDS only.

If she was on Medicare, must code the MDS a "5 day/Death in Facility", this will be a 5 assessment only to satisfy Medicare requirements.

If she died in your facility 9/4, then that is the date you use.

No CAAS needed. :)

[Sheryl218]

Doesn't it have to be a SC since she was new to hospice?

[Bella'sMyBaby]

Yes....if she would not have died on day 4 of her stay....remember, you have 14 days to complete a sig change.

[Sheryl218]

Thank-you for your answers. That is what I thought but was being told differently.

[andy3k]

I'd like to make one correction/clarification. Technically, you would do a readmission/death in facility, not a 5-day/death in facility. I know they are essentially the same assessment but it is a different code in A0310B.

[Talino]

A "death in facility" may not be combined w/ any type of assm't.

"Readm/Return" only applies when resident was covered under Med A when hospitalized, d/c return anticipated, returns within 30 days and continues on Med A.

When hospice is elected, Medicare/PPS assm'ts are only required if the resident is skilled for a condition unrelated to the terminal condition.

[andy3k]

Oops, yep, I guess I assumed they were skilled before the hospital visit. I must have invented that in my head.

[katoline]

I was taught becoming a hospice resident was a sig change, but as bella said, you have 14 days to do one.

i believe you could combine a readmission and a discharge. under the question discharge destination you could put expired. of course a reentry prior.

great questions and replies. i always learn so much here. andy, i love that you invent things in your head. i do that all the time and am certain that i got it "somewhere"

[andy3k]

Talino is correct. The resident died in facility so a Death in Facility is due and it cannot be combined with the Readmission; a Discharge - Return Not Anticipated is inappropriate for a death in facility.

[catlvr]

My hat is off to you folks who can remember and understand all of these forms and assessments and when to do them. It seems as clear as mud to me!