Ask the Experts, MDS 3.0 Items, Regulations

If a resident was only at the hospital for six hours, do I have to do a discharge?

Q: A skilled resident goes to the hospital on day 20 and was out past midnight but not 24 hours. He was not admitted to hospital and returned to the SNF within six hours. Do I need to do a discharge return expected assessment and a reentry form?

A: If the resident is not officially discharged, then you would not be required to complete a discharge assessment. The following set of criteria mandate the use of the discharge assessment:

  • Resident is officially discharged from the facility
    • Not expected to return within 30 day, or
    • Expected to return within 30 days
  • Resident is admitted to an acute care hospital
  • Resident has an observation stay greater then 24 hours
  • Every respite resident discharge

The situation you describe does not meet the criteria for a discharge but would be considered as a temporary Leave of Absence. This situation does not require completion of either a discharge assessment or an entry tracking record, occurs when a resident has a:

  • temporary home visit; or
  • temporary therapeutic leave; or
  • hospital observation stay less than 24 hours and the hospital does not admit the resident.

However, since the resident was not in the facility at midnight, the situation does have reimbursement issues. You will not be reimbursed for the day the resident was not back by midnight.