Hi.  My opinion is that this was a 2-day hospitalization followed by a discharge to the SNF---admission to the SNF followed by a discharge from the SNF and an admission to the hospital.  I interpret the regulation to apply in special situations when a person begins their stay at one hospital and then, for a variety of reasons might transfer to another hospital.  But in this situation, the hospitalization was interrupted by a SNF stay.  So I don't believe this person had a qualifying hospital stay.  But you could always call your FI and ask them how they would interpret the rule.
Thanks,
Winona Phelps
 
 
-----Original Message-----
From: Theresa A Lang [mailto:[EMAIL PROTECTED]
Sent: Monday, January 26, 2004 7:28 AM
To: [EMAIL PROTECTED]
Subject: RE: Medicare? 3 day stay

To me this situation would be a 3 day stay- two hospitalization- but look at the quote below- is a readmission to the same hospital any different than a stay in one or more hospitals?

Theresa Lang

Specialized Medical Services, Inc.

20.1 - Three-Day Prior Hospitalization

(Rev. 1, 10-01-03)

A3-3131.1, SNF-212.1

The hospital discharge must have occurred on or after the first day of the month in which the individual attained age 65 or, effective July 1, 1973, became entitled to health insurance benefits under the disability or chronic renal disease provisions of the law. The three consecutive calendar days requirement can be met by stays totaling three consecutive days in one or more hospitals. In determining whether the requirement has been met, the day of admission, but not the day of discharge, is counted as a hospital inpatient day.

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Debbie Settle
Sent: Monday, January 26, 2004 9:15 AM
To: [EMAIL PROTECTED]
Subject: RE: Medicare?

you are correct.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Tendercare
Sent: Sunday, January 25, 2004 12:30 PM
To: cmdg
Subject: Medicare?

Resident on medicaid discharged to hosp on 1-22 with acute MI. Returned here 1-24 and was discharged back to hospital 4 hours later. Before midnight. Readmitted to hosp and returned here today 1-25. She did spend 3 consecutive nights in hospital but because she came back here and discharged again I can not cover her under Medicare. Am I right?
Thanks.

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