I’m confused about the Interrupted Stay. If a Medicare A resident discharges home and then returns to the SNF two days later due to inability to care for themselves at home, is this an interrupted stay? The discharge was planned and their return was not anticipated.
This scenario can be an interrupted stay but more information is needed. In terms of the interruption window, and assuming the resident has Medicare A covered days remaining, the interrupted stay criteria is so far met. More importantly, however, the resident must continue to need daily skilled care/services to qualify for a resumption of their Medicare A SNF benefits. Per RAI Chapter 2, pg. 2-12: If a resident is discharged from Part A, leaves the facility, and resumes Part A within the 3-day interruption window, this is an interrupted stay and only an OBRA Discharge is required. An Entry Tracking record is required on reentry, but no 5-Day is required.
Answer by Eleisha Wilkes, RN, GERO-BC, RAC-CTA, RAC-CT, DNS-CT
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