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Feb
10
2011
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Posted 1 years 13 days ago ago by Roxanne Leon, RN, RAC-CT
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Combining assessments occurs when one assessment is completed to satisfy both Medicaid and Medicare PPS assessment requirements. When considering combining assessments, the time frames for both types of assessments must coincide. The most stringent requirement must be met; therefore the nursing home staff must fully understand the requirements to remain in compliance.
| Assessment Type |
Allowed or Not Allowed |
| Admission |
Allowed |
| Annual |
Allowed |
| Significant Change in Status |
Allowed |
| Significant Correction to Prior Assessment |
Allowed |
| Quarterly |
Allowed |
| Significant Correction to Prior Quarterly |
Allowed |
| Entry tracking record |
Not Allowed |
| Discharge Assesment - return not anticipated |
Allowed |
| Discharge Assessment - return anticipated |
Allowed |
| Death in facility tracking record |
Not Allowed |
| Medicare 6 day |
Allowed |
| Medicare Readmission / return |
Allowed |
| Medicare 14 day |
Allowed |
| Medicare 30 day |
Allowed |
| Medicare 60 day |
Allowed |
| Medicare 90 day |
Allowed |
| Other MEdicare Required Assessments |
Allowed |
SCENERIO
A resident receives Medicare skilled services, is in the window period for a Medicare 30 day AND is due for a Quarterly Medicaid assessment AND discharges to the hospital.
In this case, the facility may complete one assessment fulfilling all 3 requirements: Quarterly, Medicare 30 day, and Discharge Assessment – return anticipated. Keep in mind the Assessment Reference Date must coincide for all 3 requirements in order for these assessments to be combined. If at any time, the Assessment Reference Date does not coincide for all 3, then the assessments that cannot coincide cannot be combined.
See Chapter 2 of the RAI Manual for specifications on combining assessments.