When Pts leave a TCU/SNF Unit and Return

We're in the process of opening a TCU/SNF unit within our hospital and came across this scenario.  Patient is admitted to TCU.  On day 3, patient is transferred to an acute care unit (separate IP encounter).  On day 5, patient returns to TCU.  Do we treat the return to TCU as a readmission (and create another TCU account) or can we use leave of absence instead (and use the original TCU account)?

Day 1:  TCU
Day 2:  TCU
Day 3:  Med/Surg Unit
Day 4:  Med/Surg Unit
Days 5 to discharge:  TCU


  • SNF rules apply to TCUs so if the patient is admitted as inpatient to the hospital, the SNF would discharge them and then do another admission upon their return. Chapter 6 Medicare Claims Processing Manual Chapter 6 section 40
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