Regardless of whether the resident was admitted to the hospital or not they were out more than 24 hours...so a discharge must be done. If this was a new resident and no initial admission assessment was completed the discharge would be 08 and no reentry is required upon admission (unless required by your state). If an admission assessment had been completed you would use discharge 07 with a reentry upon return.
If you want to be paid anything other than default then yes you need to do a 5 day for the first stay. For the return you will need to complete a 5 day return/readmission
For your DON...the discharge/reentry tracking rules for MDS purposes has nothing to do with the facility practice of discharging. Please refer to the Discharge and Reentry Flowchart on page 2-26 of the RAI Manual. In the first box to the right of "Resident leaves Nursing facility", last bullet states (bolding mine) "Hospital observation stay >24 hr., regardless of whether hospital admits or nursing facility discharges." points to "Discharge tracking form REQUIRED (This bolding and CAPS is theirs, not mine.)
[EMAIL PROTECTED] wrote:
You need to contact the hospital to determine if he was actually admitted or was listed as observation status. If observation - then you don't count the day he went out (5/7). Then change your ARD day to 5/8 or use grace days depending on the RUGG you are trying to get for your 5 dayJeff
[EMAIL PROTECTED] wrote:
Ok this maybe long sorry...Pt admitted 5/4 Med A with Lung CA and pantocytopenia was hospitalized for weeks and recieved blood just about qod (i told them not to accept them--thats another story) anywaywent for hosp on 5/7 for a scheduled transfusion at 4:30 pm hospital called at 2am on 5/8 to say he was admitted to the hospital-----our nurse counted meds and sent back to the pharmacy but that was it no other discharge paperwork was done-----hospital social worker calls the floor on 5/8 pt to to return on 5/8 at 5pm---he did BUT there wasnt any readmission done it was treated as if he went to a doctors appt.My question He was discharged...out for 24 and a half hours so I do a 5 day assessment for that period CORRECT???? then a discharge return anticipated then a rentryreadmitted on 5/8 went out on 5/12(yes another transfusion) so i will do another 5 day assessment CORRECT??? then a discharge return not anticipated...I just need to know if I'm going crazy because the DON says NO he was not discharged from the facility....(unbelievable what I'm dealing with at this place)Needless to say we are not taking him back....Can you believe they are going to listen to me LOL------ day late and a dollar short!!!!!!!!!!!!!!!!Thanks for the help :)
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