Headshot of nursing expert Amy Stewart

Q: How does an interrupted stay affect future MDS assessments?

A: The interrupted stay policy applies when a resident on a Medicare Part A stay discharges from a SNF and resumes skilled care in the same SNF for a Part A-covered stay during the
interruption window.

That window is the three-day period starting with the first day of the Part A discharge and including the two following calendar days. If a resident on a Part A stay discharges from Part A, the resident must resume Part A services by 11:59 p.m. of the third consecutive non-covered day to constitute an
interrupted stay.

If the resident remains in the facility after Part A services end and skilled services resume before 11:59 p.m. on the third non-covered day, it is an interrupted stay. Since there was no physical discharge, no new assessments are required.  However, if the Part A stay ends due to physical discharge and the resident returns for skilled services before 11:59 p.m. on the third non-covered day, OBRA discharge and entry tracking records are required. A PPS discharge assessment is not. In either instance, the nurse assessment coordinator and team should consider an optional Interim Payment Assessment. 

If the resident returns for skilled services after the third day, it is not an interrupted stay; OBRA and PPS discharge assessments are required. Upon return, an entry tracking record and a new 5-Day PPS assessment are required. Subsequent OBRA assessments depend on the type of discharge. If a return is anticipated, the assessment schedule continues where it ended. If a return is not anticipated, a new OBRA Admission assessment is required; it can combine with the 5-Day PPS assessment.