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If a nursing facility resident with MI/MR is admitted to a hospital for a short time and then wishes to return to the facility, must a Level II evaluation be completed prior to return to the facility?

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If a nursing facility resident with MI/MR is admitted to a hospital for a short time and then wishes to return to the facility, must a Level II evaluation be completed prior to return to the facility?

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No federal requirement specifically addresses this issue. A Level II evaluation is required when there is a change in a resident’s condition. When a resident is returning from a hospital stay, there may be a clear change in condition. In these cases, a Level II should be conducted in the hospital to determine whether and under what circumstances the resident should be readmitted to the NF (including what specialized services must be provided). In other cases it might take a period of readjustment back at the NF before changes to the resident’s condition become apparent. In these situations the NF should use the MDS Significant Change in Status Assessment (SCSA) to evaluate whether a resident review is indicated (i.e., whether a change in condition is present).

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