Can I put my asymptomatic positive residents under a skilled stay to capture an increase in reimbursement?

In relation to COVID-19, skilled nursing facilities are continuing to struggle with outbreaks among their residents and staff. The television coverage addresses hospitals, but our industry is being affected just as much, if not more so. Thank you and your staff for continuing to provide care to our elders.  

The waivers for the three-day hospital stay, as well as the 60-day wellness period, are still in effect. This can help the facility financially. However, I caution you to evaluate skill. If a resident is asymptomatic, really look at what skill is being provided. 

I am concerned about audits and denials going forward. When a resident is diagnosed with COVID-19 and they are symptomatic, it behooves us to place them on a skilled stay. As long as we are providing skilled services, it should not be an issue. If they are in a private room, we can capture isolation in section O on the MDS, significantly optimizing reimbursement. 

Issues that have arisen are that some residents are receiving part B therapy. If they are being switched  to part A, a new therapy evaluation will need to occur. This needs to be coordinated and communicated on the team.

Documentation also needs to be in place. Think of section GG.  Denials are occurring because the data is not documented in the medical record. If we put them on Medicare Part A the day of the diagnosis (not necessarily the day of the swab), we may have time to get that documentation. 

Certifications also need to be sent out to ensure technical requirements are being met. Ensure the staff are aware that skilled documentation is required on these residents. Also coordinate with the managed care plans to see if they will cover.