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2. Regarding Medicare Fee for Service (not Medicare Advantage), which is TRUE?
3. The Two Midnight Rule
4. Which of the exclusions listed below apply to the Two Midnight Rule:
5. You have a longstanding Medicare patient (not Medicare Advantage) come in with COPD exacerbation. This presentation is as before, and he usually stays 4-5 days before stabilizing enough to return home. You expect this admission to be as previous and to stay more than two midnights, and so you ordered for inpatient care on admission. The patient responded more quickly than expected and on the evening rounds of day two, asked to go home. Clinically, you agree with his request. Because the patient did not pass two midnights, you should
6. A surgical procedure was admitted electively as inpatient and is on the “Inpatient Only” list. After the procedure, the Attending Surgeon states she disagrees with that determination because the procedure was “not that hard”. You have knowledge of inpatient and observation status determination, so you offer to help her work through this process. You recommend for her to (choose ALL that are appropriate)
7. Medical admissions (CHF, pneumonia, etc.) have a specific Medical Inpatient Only (MIO) list that gets updated each year by CMS.
8. A Medicare patient meets medical necessity for inpatient care services for Pneumonia. They stay in the facility for three nights of care and on day four, are ready for discharge. This 88-year-old is very weak, and you feel that they need a post-acute stay for short term rehab to make sure of a safe transition to home. PT has agreed due to gait instability and states that discharge to home is “unsafe” based on their findings. Which of the following is/are true? (choose ALL that are correct).
9. On day two (D-day) of a hospital stay where the patient was admitted as inpatient, what would help secure this inpatient status? Choose all that apply.
10. Which of the following COPD scenarios would most likely merit INPATIENT hospitalization from initial presentation (active management beyond 2MN?)?
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