really?

[crazyforthis]

Question please... Mr X is a Medicare pt who admits 10/17 to our SNF and dc's back to acute hospital 10/27, he is then readmitted to our SNF on 10/28 and again dcs back to acute hospital 11/6, again he readmits to our SNF on 11/7 and you guessed it, back to acute hospital 11/8...

I have had plenty of time to get assessments done on him except for this last admit here on 11/7. Do I code him as 01/01/10? 99/99/10? A one day, not even 24 hours, admit is not enough time to do anything at all with him as far as MDS goes...

Now my Rant- yesterday I have begged the admitting person here along with our Director and the Doctor and the Nurse Manager to please NOT accept this patient back again without first requesting he have a psych eval as the last 2 dc's back to acute care where related to him not getting more IV MS04 so he states he will kill himself and states his plan on how he will do this. When he gets to ER he tells them his chest wall pain is 10/10, gets his drug eventually then recants his threats of hurting self and even states he said it just to get the drugs... really? Can we please get the psych eval to protect not only ourselves but also this patient and all the others here too? Ok, done ranting for now... thank you all!

CRAZYforthis!

[DixieRedHead, ASN, RN]

I don't know about the regs in your state, but if we have a bed and they want to come back we have to accept them for 15 days.

[imkaren2]

We'd be admitting him too. I'd use the d/c date as the 5-day and combine them. 11/8/11. You'll want the RUG to cover for a day is what I'm told even though we don't charge for day of discharge.

[montecarlo64, ASN, BSN, LPN]

I too have used a combo 5 day and DC for overnight or stays for less than 24hours...I use the DC day for the ARD....I also do not think you can refuse to take him back, unless his hospitalization exceeds 15 days:(