Question!

Specialties MDS

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Specializes in LTC-Geriatric-PPS-MDS.

If medicare pt was deemed unskillable and had Last cover day on the 39th day of medicare- she reclassed to medicaid..

If said patient met her 60day wellness period then went back out to hospital for 2weeks and came back...

Does she resume from her 39th day or pick up with a whole new 100days?

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Specializes in LTC, Hospice, Case Management.

If she/he has had a 60 day break in the spell of illness...when they have another 3 day qualifying stay, they come back with another full 100 days.

If they came off m/c at day 39 and then got sick again within the 30 day window they could come back at day 40.

If they came off m/c at day 39....went to the hospital w/ a 3 day stay BEFORE the 60 day break in illness, they would come back on day 40.

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Specializes in LTC-Geriatric-PPS-MDS.

Thanks! I thought I had it right- thanks for the reassurance. I gotta go talk to the BOM- cuz this lady gots a new 100days! When they said she only has the remaining 50. Thanks again!

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