MDS Alert

Published on Wed Aug 18, 2004 PDF

Question: Would the following count as a break in the spell of illness?

A resident who has exhausted his 100 days of SNF coverage is discharged to an assisted living facility on the same campus as the nursing home. He continues to receive daily tube feedings providing the majority of his fluids/nutrition and daily LPN observation in the ALF. Could he still accrue a 60-day break in the spell of illness for purposes of earning another 100-day SNF benefit? 

Answer: Yes. "Once the resident is discharged to the ALF, Part A  hospital benefits are no longer in question," says Marilyn Mines, RN, a consultant with FR&R Healthcare Consulting in Deerfield, IL. "The resident is not in a skilled facility and the MDS discharge tracking form would indicate that the resident was discharged to the community without return anticipated." Thus, tube feedings, daily RN services or home health services don't interrupt the break in the spell of illness since the services are being provided outside the inpatient hospital or Part A nursing home environment, Mines concludes.