Nursing Home Med A Eligibility?

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Specializes in MDS/PPS.

I appreciate everyone's input in here and I have a question that I would really appreciate some feedback on. I have a opinion but have been debating this with administration.

Would you follow a resident under nursing home Medicare A for the following reasons and if so are you aware of actual documentation supporting.

Resident has a unstageable due to necrosis pressure ulcer on their sacrum that is being treated daily and followed by our outside wound care Dr. weekly.

Also a resident that has an arterial ulcer to heel with dressing treatment daily and is being followed by our outside wound care Dr. weekly.

I would really appreciate any comments. Thanks

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Specializes in MDS/ UR.

Medicare coverage is possible with appropriate qualifying stay and complex wound care daily.

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Specializes in LTC, Hospice, Case Management.

I'm not sure why you wouldn't cover this. Your supporting documentation would reflect in weekly wound notes, your daily treatment orders, your nursing documentation for skilled services monitoring the site for signs of infection as well as monitoring/treating for related pain. Your care plan will also help support the level of skilled care.

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Specializes in Gerontology, Med surg, Home Health.

Daily wound care is enough of a skill to keep the person on Med A...unless, of course, they have run out of days or haven't had a qualifying stay in the hospital.

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Specializes in critical care, ER,ICU, CVSURG, CCU.

has there been reccent hospitalization of 72hrs....ie three midnights?

and does the resident have any remaining qualify medicare A days left?

your documentation, and treatment are adequate, if there were any medicare A days left, I would include physical therapy also....

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