MDS Alert

Published on Thu Oct 20, 2005 PDF

Use this 'cheat sheet' to avoid accidentally cheating Medicare

Stamp out compliance woes and overpayments by making sure your facility doesn't count the following types of physician visits and orders at P7 and P8.

1. Standard admission orders. The prohibition against counting standard admission or readmission orders applies regardless of whether the ordering clinician gives the order at one time or at different times on the date of the resident's admission or readmission. Do count new or altered orders written on the day of admission that address a resident's unexpected change/deterioration in condition.

2. Return admission orders, renewal orders, or clarifying orders without changes.

3. A sliding scale dosage schedule written to cover different dosages depending on lab values. This does not count as an order change simply because the nurse administers a different dose based on the sliding scale guidelines, states the RAI manual.

4. Visits or orders prior to the date of admission or reentry.

5. Pharmacists' orders.

6. A monthly Medicare certification. This is an order renewal, states the RAI manual.

7. Notifying the physician that  a PRN order has been activated when the PRN order is already on file does not count as a new or changed order.

8. Orders for transfer of care to another physician.