Posts tagged ‘recert’

October 25, 2011

Answers to when we have to report admissions

Too often we learn about transfers of our patients after the fact. CMS released its 3rd quarter Q&As recently and addressed the item, including the turnaround time when we have to report the transfer.

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Question 1: A patient is seen monthly. On a monthly visit, which falls within the last five days of the certification period, the assessing clinician discovers the patient had a qualifying hospital admission since the last monthly visit that our agency was not aware of. Do we complete a Transfer, Resumption and Recert or just the Transfer and Resumption?

Answer 1: When the agency learns of a qualifying Transfer after the patient returned home, a Transfer and Resumption is required within 2 calendar days after learning of the inpatient stay. In this situation, a Transfer is required; and, since the time frame to complete the Resumption overlaps with the timeframe to complete the Recertification, the ROC assessment should be completed, fulfilling both the ROC and Recert requirements.

Looking for all the Q&As?

April 26, 2011

Major improvement or decline require a follow-up assessment

Question: Let’s say that I did a recert on 4/11/2011 and then the patient had an outpatient mastectomy 4/12/2011.  I went to see her on 4/13/2011, which was the first day of her recert. Would this visit be considered a SCIC or can we do as a regular visit and a telephone order for the orders of the mastectomy care?

Lisa says: A follow-up assessment is required for a major improvement or decline in condition, but your policy defines  major improvement or decline. You must complete another follow-up assessment if the circumstances meet your policy.