Sot & eot before 5 day ard

[ibtootie]

Mr. X admits to SNF on 10/11 for IV Antibiotics for Osteomyelitis and foot amputation. Physical Therapy eval deems him too high level in function for PT, but OT determines need for ADL teaching. If Mr. X meets his therapy goals by 10/14 and is discharged from therapy services before the 5 day ARD, but remains in SNF for continuation of IV antibiotics, is a COT required?

[imkaren2]

If you anticipate therapy coming out very soon, I would look at setting an ARD on a day 1-6 to capture the highest RUG be it nursing or rehab. Then the clock starts. If you get a nursing RUG, you will probably keep it due to the IV and wound, and skin treatments. But all this will depend on how many minutes rehab gave and the ADL. Does that make sense?

[imkaren2]

Wait! Is the amputation new? If it is, therapy shouldn't be out, they need to be shrinking it and doing rehab! Ok, good luck there.

[bettylafea]

I say you can choose day 5, 6 or 7 for 5-day ARD, combined with EOT( day 1 , 2 or 3 from last day of therapy). No SOT because it is not a short stay. No COT Observation follows because therapy had ended. You will get paid rehab RUG for days 1-4 when therapy is on, then nursing RUG for day 5 (10/15) onwards considering the patient is still skilled for IV meds and surgical wounds/post amputation.

[imkaren2]

Well, doing an EOT will only depend on what that first RUG is, if it is a rehab RUG then yes you will need it, if there aren't enough minutes, or the ADLs are low the initial RUG may be a nursing one, in that case, an EOT to switch from rehab to nursing isn't required.

[ibtootie]

Therapy ended on day #4. Using day 5 as the ARD, He didn't have enough therapy minutes to get a rehab RUG, only CA1. I anticipate that his next RUG will be CA1 also.

[imkaren2]

Ok, so maintain the RUG and no EOT or COT is required.