Medicare
What coverage is provided for Medicare Parts:
A -
B -
C -
D -
A - Hospital insurance (acute, SNF, hospice, & home health)
B - Medical insurance (outpatient appointments, home health, DME, preventive services)
C - Advantage plans (bundled plan that include Parts A, B, and usually D)
D - Drug coverage (prescription medications
True or False:
Patients admitted to the hospital from a SNF who plan to return to the same SNF, require an updated DMAS-95.
False
Would a Medicare beneficiary who has exhausted their benefits (e.g. a beneficiary has reached the number of lifetime reserve days for the Medicare inpatient hospital benefit) receive a MIM?
No
Per the Conditions of Participation, who is permitted to complete a discharge planning evaluation and plan for the patient?
A registered nurse, social worker, or other appropriately qualified personnel.
What year was Riverside Health established?
In 1915 when a charter was granted for the Newport News General and Non-Sectarian Hospital, Inc. It was a 50-bed hospital on Huntington Ave.
What is the maximum number of days a patient can be out of the hospital after a 3 consecutive day qualifying inpatient admission and still go to a SNF?
30 days
Give two examples of diagnoses that would likely require a Level II screening to be completed.
IDD, Autism, Cerebral Palsy, Epilepsy/Seizure Disorder, Friedreich's Ataxia, Multiple Sclerosis, Muscular Dystrophy, Spina Bifida, Mental Illness with two or more psychiatric admissions in the last two years, Patient cannot read or write
Who can sign the Important Message from Medicare (MIM)?
The patient or their Appointed or Authorized Representative.
The hospital's discharge planning process must identify, at an early stage of hospitalization, those patients who are likely to suffer adverse health consequences upon discharge in the absence of adequate discharge planning. When is the initial assessment performed?
Within one business day of admission.
What does the acronym NASA stand for?
National Aeronautics and Space Administration
How many lifetime reserve days does a Medicare beneficiary have that can only be used once?
60 days
Patient is admitted to a SNF under rehab with the plan to transition to long-term care. Which screening is required prior to admission?
DMAS-95 only
Hospitals must deliver the first copy of the MIM at or near admission, but no later than ______ calendar days following the date of the beneficiary's admission to the hospital.
2
The hospital's discharge planning process requires regular re-evaluation of the patient's condition to identify changes that require modification of the discharge plan. The discharge plan must be updated, as needed, to reflect these changes. How often is the discharge plan updated at Riverside hospitals?
Every 3 days
How many time zones in the world?
24
How many consecutive days must a Medicare beneficiary be out of the hospital or a skilled nursing facility in order to recycle their Medicare benefits?
60 days
What are the three required items Change Healthcare needs in order to complete an application for long term care Medicaid?
1. Approved LTSS screening
2. Name of accepting (or interested) facility
3. Expected discharge date
When would a Medicare beneficiary not receive an Important Message from Medicare (MIM)?
1. Transfer to another acute facility (another hospital, LTACH, IPR, or inpatient pysch admission)
2. When they have exhausted their benefits
3. Elect for hospice
4. Not admitted as an Inpatient
5. Leave AMA
The hospital must assist patients, their families, or the patient's representative in selecting post-acute care provider by using and sharing data that includes, but is not limited to home health agencies, skilled nursing facilities, inpatient rehab facilities, or long-term acute care hospitals data on quality measures and data on resource use measures. What website do we direct patients to visit to view this quality data?
If this popular entree served on Wednesdays at the RRMC cafeteria were served in Gainesville, Georgia, it would be illegal to eat it with a fork.
Fried chicken
How many benefit periods does a Medicare beneficiary have?
Unlimited
Per DMAS, patients who are admitting to a facility for hospice care DO or DO NOT require an LTSS screening?
Do not
If a patient was admitted on Monday, the first copy of the MIM was delivered on Wednesday, and the patient is to discharge on Friday - does another copy of the MIM need to be provided?
No
The hospital, as part of the discharge planning process, must inform the patient or their representative of their freedom to choose among participating Medicare providers and suppliers of of post-discharge services. Name one of the three places you can find freedom of choice lists?
1. iCare - Case Manager Learning Home - Case Manager Links section
2. Case Management shared drive
3. Careport - send via text or email
What two cities are found in the phonetic alphabet?
Lima and Quebec