MDS Alert

Question: Our SNF admitted a resident with a diagnosis of pneumonia and a stage 3 pressure ulcer to our SNF from a subacute SNF. The resident's family requested that he be transferred because they didn't like the care he was receiving in the transferring SNF. The resident received IV fluids and IV antibiotics in the SNF. Can we code services he received in the transferring SNF?

Answer: The admission to your facility is independent of an admission to any other SNF. You must complete a 5-day Medicare assessment and must also meet the OBRA requirements for an initial assessment, if the resident remains in your facility for 14 days. You can combine the OBRA assessment with the 14-day Medicare assessment as long as it is completed within 14 days of admission. You can count any skilled services that occurred within the look-back period. Since this resident received IV fluids and IV medication in the SNF, you have more flexibility with the ARD (assessment reference date) choice. As long as the services you want to count are within the required lookback time period, you may also use information from the hospital stay. In either instance, you must have documentation to support that these services were rendered during that time frame.

Answers to questions provided courtesy of Marilyn Mines, RN, RAC-C, BC, director of clinical services for FR&R Healthcare Consulting in Deerfield, IL.