Q: We have a resident that was discharged to the acute hospital and, due to payment issues, was formally discharged from our facility. We expect him to return within 30 days. Do we need to consider him as a return/anticipated and continue his schedule (even though he will have a new medical record) or can we just continue the OBRA schedule he was on prior to his discharge to acute care?
A: The determining factor in whether or not his schedule continues is how the patient was discharged. If the discharge code from the discharge assessment was A0310F=10 (Return not anticipated, you would begin the OBRA schedule with an admission assessment. If, however, the discharge code was A0310F=11 (Return anticipated) and the patient returns within 30 days you would continue with the OBRA schedule and determine if a SCSA is appropriate or next quarterly or annual, etc. Opening and closing medical records is a facility policy rather than a regulatory issue and has no impact on the OBRA schedule or rules.