Resident discharge less than 24 hours.


I have a resident on Med A, she was sent to ER for blood tranfusion 10/28 at 10PM then came back 10/29 at 9AM. She was discharged in the system by admissions. Now, do you create a new Med A tracking(5D, 14D...) or continue with existing assessment since she was not out more than 24 hours?


1,010 Posts

Specializes in ER CCU MICU SICU LTC/SNF.

Resident Is Sent to Acute Care Facility, Not in SNF over Midnight, and Is Not

Admitted to Acute Care Facility RAI p2-69

If a resident is out of the facility over a midnight, but for less than 24 hours, and is not admitted to an acute care facility, the Medicare assessment schedule is not restarted. However, there are payment implications: the day preceding the midnight on which the resident was absent from the nursing home is not a covered Part A day. This is known as the "midnight rule." The Medicare assessment schedule must then be adjusted. The day preceding the midnight is not a covered Part A day and therefore, the Medicare assessment clock is adjusted by skipping that day in calculating when the next Medicare assessment is due. For example, if the resident goes to theemergency room at 10 p.m. Wednesday, day 22 of his Part A stay, and returns at 3 a.m. the next day, Wednesday is not billable to Part A. As a result, the day of his return to the SNF, Thursday, becomes day 22 of his Part A stay.


38 Posts

Thanks, so glad I have someone to ask for info.