Step-by-Step Coding Guide for A2000: Discharge Date

Instructions:

1. Identify the Discharge Date:

   • The discharge date is when the resident officially leaves the facility. This includes both anticipated and unanticipated departures.

2. Documenting the Discharge Date:

   • Record the actual date of discharge in A2000. Ensure this date is accurately captured from the medical admissions or transfer records.

3. Specifics for OBRA Discharge Assessments:

   • For OBRA Discharge assessments, ensure that the Discharge Date (A2000) and the Assessment Reference Date (ARD) (A2300) are the same.

4. Exclusions from the Discharge Date:

   • Do not include periods of leave of absence or hospital observational stays of less than 24 hours unless the resident is formally admitted to the hospital.

5. PPS Discharge Assessment Requirements:

   • A Part A PPS Discharge assessment is necessary under the SNF QRP when a resident's Medicare Part A stay concludes but they remain within the facility.
   • The PPS Discharge assessment should be conducted at the end of the Medicare Part A stay. If this coincides with or is one day before the facility discharge, combine it with the OBRA Discharge assessment, ensuring the ARD matches the discharge date.

6. Combining Assessments:

   • When the Medicare Part A stay ends while the resident stays in the facility, set the ARD for the PPS Discharge assessment to the last covered day under Medicare Part A.
   • This PPS Discharge assessment can be combined with most OBRA-required assessments, provided all criteria for each are met. Refer to Section 2.10 of the CMS manual for details on combining PPS and OBRA assessments.