Medicare requires a Medicare Part A PPS Discharge Assessment, effective October 1

Under the IMPACT Act, SNFs are required to submit patient assessment data regarding a resident’s admission to and discharge from a Medicare Part A Assessment, effective as of October 1, 2016. Providers who fail to submit this required data (used for quality measures calculation) may face a 2%-point market basket rate reduction effective October 2018.

Things to note:

  • A Medicare Part A PPS Discharge Assessment is necessary even when a resident’s Medicare Part A stay ends and the resident remains in the facility.
  • The Part A PPS Discharge Assessment is still required even when there are no other MDSs required.
  • The Part A PPS Discharge Assessment is necessary when the resident is physically discharged from the facility.
  • According to CMS, the Part A PPS Discharge cannot be combined with unscheduled PPS assessments (OMRA).
  • According to CMS, the Part A PPS Discharge may be combined with OBRA and scheduled PPS assessments. While it can be combined with these assessments, the Part A PPS Discharge cannot be used as a substitution for OBRA or scheduled PPS assessments.
  • A Medicare Part A Discharge Assessment is not required when a resident passes away during a Part A stay.
  • The assessment reference date of the Part A PPS Discharge MDS must match the date recorded in section A2400C. This date is determined by the end of Medicare date.
    • The end of Medicare date is coded by whichever of the following scenarios occurs first:
      • Date SNF benefit ends
      • Effective date recorded on the Notice of Medicare Non-Coverage (NOMNC)
      • Date of last paid day of Medicare Part A coverage when resident’s payer source changes
      • Date of resident discharge from the facility

Are you confused? Having trouble remembering which assessment to do when? HCPro can help!

  • Sign up for our webcast, “Successful PPS Scheduling: Receive optimal reimbursement while reducing default rates and provider liable days,” January 13, 1:00 – 2:30 PM ET
  • Visit our marketplace for information about Long-Term Care MDS Coordinator’s Field Guide, a book to help coordinators and other nursing home staff complete the MDS 3.0 accurately, interpret MDS sections, identify and resolve MDS discrepancies prior to submission, and guide facilities to positive survey outcomes and accurate reimbursement.

Quarterly Member Calls

Members-only calls

Enjoy upcoming and past Quarterly Calls with your AMBR Membership! Click here!

Access sample white papers, tools, analysis, and resources.

Featured Event

Tuesday, October 6, 2020 - 07:00

2019 Revenue Integrity Symposium

The 2020 Revenue Integrity Symposium covers topics essential to revenue integrity, Medicare compliance, and the revenue cycle in acute care and long-term care settings.