overuse of grace days?

poohmdsnurse · Feb 11, 2008

For one thing ... everyone is out for the all mighty dollar and if it means taking grace days You will do it ! or lose your job.Why would they give them to you for you not to use them ? The only time you will find yourself using grace days is on the first two assessments usually and that is because therapy wants to get a very high or even a ultra high category for you and occassionally you might use them on 30/60 if a patient is sick and therapy needs to go beyond the ARD. You will have to pay for therapy delivering that amount of time why wouldn't you want the highest amount of money you can get back from Medicare.

Also, the PPS spinner is very easy to understand and a life saver once you figure it out. Point the arrow Day 1 is the patients admitt day- it then tells you that patients ARD windows and completion dates. Make sure you have the leap year one for 2009- they have 2 kinds of spinners.

Nascar nurse, ASN, RN · Feb 12, 2008

For one thing ... everyone is out for the all mighty dollar and if it means taking grace days You will do it ! or lose your job.Why would they give them to you for you not to use them ? The only time you will find yourself using grace days is on the first two assessments usually and that is because therapy wants to get a very high or even a ultra high category for you and occassionally you might use them on 30/60 if a patient is sick and therapy needs to go beyond the ARD. You will have to pay for therapy delivering that amount of time why wouldn't you want the highest amount of money you can get back from Medicare.

This is certainly my coorporations philosphy as well. 98% of the time I use grace days on the 5day MDS. This is what is expected of me. I have done this for years now, any have never seen the "red flag raised" so I quit worrying about it long time ago (probably just jinxed myself tho! )

Rexie68 · Feb 12, 2008

i concur with the other nurses. i use grace days on almost every 5 day to capture the highest rug level. we've never had any problems. it gives therapy some flexibility in their scheduling, and usually means they don't have to work over the weekend/holiday, etc. there are some tricks to this job...and that's one of them. another thing that some overlook...get the mar from the hospital...any iv meds 14 days back from the ard count in section p and can give you a higher rug level, too! blood transfusions are also counted. it's amazing that one ivp dose of pain med can increase your reimbursement $30/day. anyway....good luck and welcome to mds insanity!! :bugeyes:

RN 4 Life · Mar 14, 2008

As an MDS Coordinator it is part of your responsiblity to maximize reimbursement. I think sometimes nurses feel this is a negative thing and look at it as shameful. Yet, it is a very important part of allowing the facility/center to pay for the care and services the patients need. Nothing is for free, especially healthcare! I also look at it as a way of advocating for the patient. Everytime I utilizie my patients Medicare benefit I look at it like I am giving them something that they are not only entitled to but that they have worked there whole life for. Dont be afraid to use grace days, just use them as the regualtions allow us to use them. If you are in this role, maximizing reimbursement is your responsiblity and it is important that you become good at ways to do it....for you, for your patients and for the center/facility you work in. If you are grounded by your strong ethical beliefs to do the right thing, you will likely develop the good practices and use the grace as they have been intended......Dont be afraid to use Grace Days ;-)