Ask Diane: What should I do when the ARD and R2B dates overlap the end of a quarter?
Q: If a Medicaid resident has an assessment completed with an ARD of 06/29 and an R2B of 07/05, is that assessment counted in the case mix for both the quarter ending in June and the quarter ending in October? Or would another assessment with an ARD in July, August, or September need to be completed for the quarter ending in October?
Diane: Good question. Since Medicaid is a state-administered program, each state has its own guidelines and regulations. Regarding this situation, some states will look at the ARD and others will look at the R2B. Your best bet would be to check with your state’s Medicaid office. If you don’t have the contact information for your state’s Medicaid office, you can look it up in CMS’ contacts database.
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Diane Brown
Diane Brown is a long-term care regulatory specialist at HCPro. She is also a long-term care educator and consultant with over 25 years of operational experience in healthcare. For Diane's complete bio, visit the About page.
Diane has written 44 posts.
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PPS Alert for Long-Term Care
PPS Alert for Long-Term Care is your monthly resource for MDS information, regulatory news, and tips to keep your facility running smoothly. Columnist Diane Brown and Wayne van Halem, AHFI, CFE, answer readers' toughest questions.
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Comments
I am from Wa. State. The state looks at the admission date and use the RUG score you achieved on that MDS with ARD of 6-29 and applies that to the number of days the patient was in your facility during the 2nd quarter and will apply the same RUG score for the number of days the pt is in your facility during the 3rd quarter until the next MDS is due. So if the pt was admitted on 6-25 you will have 6 census days for that pt on your 2nd quarter report using the RUG score achieved from that MDS. Assuming the pt discharges 7-15 there will be 14 days using that RUG score for July.
When a resident is funded through a long term care capitated assistance program and receives therapy 5 days a week, should we make him skilled and bill Part A for the skilled level of care provided?
Linda, to see Diane’s response to this question go to http://blogs.hcpro.com/mdscentral/2009/07/medicare-part-c/
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