Med A Skill

When you say she had a 60-day wellness period, does that mean the St IV sacral ulcer you initially provided skilled service was resolved or reduced to a St II or less? If this ulcer hasn't changed in Stage, even if it changed in size, the skilled level of care would not have ceased.

If the sacral ulcer simply recurred after a 60-day or more of absence, was present during hospitalization, then you can skill the resident again for that condition.

The sacral wound just reduced in size and still present when discharged to hospital. Does this mean she cannot be covered under Med A?

]Technically, no since the 60-day wellness period was never achieved. This is no different with a resident who is on a continuous tube feeding. Check with your Medicare biller. When a resident exhaust benefits but continues to require skilled care, the facility has an obligation to submit "benefit exhaust bill" monthly to the FI. This enables CMS to track a beneficiary's benefit period.