C.A.R.E.
Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency
This is the time when friends and family are asking patients and residents to take a trip out of the facility to enjoy some holiday cheer. There are a few comments I must share with you around this scenario.
- Practical Matter Criterion
If the patient is on Medicare Part A, do not interpret the regulation so strictly that the patient is denied an outing or leave because you are worried about Medicare payment. “As a practical matter, considering economy and efficiency the services can only be provided in a SNF.” Remember that if the patient leaves and returns within the 30-day window, access to Medicare benefits exists. (30-day rule.)
