MDS Alert

Published on Mon Sep 07, 2020 PDF

Question: I am being pressured by some of the folks in our finance office to skill all residents if we get a positive COVID-19 case in our facility. I feel like this can’t be correct, but I’m not sure. Are MDS coordinators supposed to skill everyone if they get a single positive case?

Massachusetts Subscriber

Answer: No, the Centers for Medicare & Medicaid Services (CMS) is explicit in saying that a COVID-19 diagnosis does not entitle an individual resident to beneficiary status. “A COVID-19 diagnosis would not in and of itself automatically serve to qualify a beneficiary for coverage under the Medicare Part A SNF benefit. That’s because SNF coverage isn’t based on particular diagnoses or medical conditions, but rather on whether the beneficiary meets the statutorily-prescribed SNF level of care definition of needing and receiving skilled services on a daily basis which, as a practical matter, can only be provided in a SNF on an inpatient basis,” CMS says in a COVID-19 Medicare Fee-For-Service (FFS) FAQ.

Therefore, it would be an even bigger stretch — and expressly not compliant with Medicare rules and regulations — to skill residents across a facility for one positive diagnosis.