What MDS do I open? MCR patient. - D/C, Re-entry, Admission+5day or Sigchange+5day?

[MDSnewb]

MDS - MCR patient

Patient was discharged to the hospital during facility stay 12/13/16 @ 830am and was admitted for 1 day (pass 24 hours) due to Gallstone and had surgery and returned to the facility the next day 12/14/16 @ 1650pm. What assessments do I open?

Patient has a different admitting diagnosis to the facility.

She was admitted to the hospital, so this does not qualify for the midnight rule correct?

Do I open up a discharge MDS, Entry MDS and admission/5 day or sig change/5day?

Totally confused.

Thank you

[Talino]

If resident was receiving Med A benefits prior to hosp'n:

1. 12/13 - DC
   
2. 12/14 - Entry
   
3. 5 Day - restart the PPS sched. The midnight rule does not apply.
   
4. SCSA - only if criteria met; the team has up to 14 days to determine if a sig. change occurred. You may combine SCSA and 5 Day.
   

If not Med A prior to hosp'n, do #1, 2, & 4. #3 is not required.

[MDSnewb]

Thank you so much Talino. :)

Since she came in with a different diagnosis then her prior admission to the facility, will this be a new admission/5day?? or just a plain 5 day will be okay unless the team determines that a sig change has occurred?

What qualifies for a sig change to occur? I'm trying to look it up in the MDS manual but I cant seem to find out where that section is under.

[Talino]

If the discharge was "Return Anticipated", you do not do another Admission but just the 5-day. You will use the same diagnosis that was identified initially when resident first received skilled service. The new diagnosis has no bearing since this was only a 1-day hospital stay.

The Sig Change guideline is in p2-22 of the RAI manual.