If a resident is cut from skilled services but a new skilled need arises during the interrupted stay window, would the facility be allowed to re-skill the resident?
The Medicare Benefit Policy Manual, Chapter 8 states that “Another qualifying hospital stay would not be required, providing the care furnished is clearly related to a hospital stay in the previous spell of illness and represents care for which the need was predicted at the time of discharge from such hospital stay.” If a resident readmits during the interruption window with a new unrelated condition, the resident would not be eligible for skilled care as the new condition would require a new qualifying hospital stay.
Have questions? Contact us to learn how we can help.
PDPM coding questions? Proactive has answers. Click here to see all these PDPM Coding Questions blogs.
Get more resources in our shop!
Patients rely on you. You can rely on us. Find toolkits, webinars, on-demand trainings, templates, and much more to meet the needs of your facility. Click here to visit our shop.