PDPM Admission

Another follow-up with regard to setting ARD:

If it is a Managed Medicare, do I separate admission from 5 day assessment? Or I can combine too?

My understanding is you still do an admission and yes you can combine it with the 5 day. For managed cares we just do the admission, no 5 day and then contine with a 14 day, 30 day, 60 day, 90 day.

Just to add to ...

Admissions on or after October 1st, Admission and 5-day may be combined. Admissions prior to October 1st, during the last week of September, combining the 5-day and Adm is a bit tricky.

Just remember, the OBRA Adm still has up to 14 days to be completed. Med A admission during the last week of September must have an ARD no later than 9/30.

Example: If resident is admitted on 9/28, your 5D ARD should be no later than 9/30. Hence it would be unwise to combine the OBRA Admission with a very short look back period.

Not To Forget: All currently Med A residents admitted prior to October 1st with benefits extending after September 30, require the IPA with ARD set no later than October 7.

Example: Resident admitted on 9/28 need a 5-day with ARD no later than Sept. 30. He will also need the IPA w/ ARD set between Oct 1-7.

Medicare Advantage: Do not combine the Adm and 5D. The 5D for medicare advantage are not to be submitted. Most MAO only need the HIPPS (Z0100A) yielded by OBRA Adm so a standalone 5D may not be necessary.

You should ask the MA carrier if they will be following the new PDPM scheduling or still rely on the prior - 14, 30, 60, etc. If they do, does your software still allow the creation of theses types of PPS assm't on or after October 1st.

Wow, I'm interviewing for a MDS position this week and you guys sound like you're speaking a foreign language.