Mr. E. admitted on October 10 and is paying privately for his stay. It is clear that today, day 12 of the stay, he has suffered a significant change in clinical status related to extension of his stroke. The physician does not want to admit him to the hospital because the nursing facility can provide the necessary care and services. The assessment reference date (ARD) for his Admission assessment is yesterday, October 20 (day 11). From an MDS standpoint, what is the correct course of action?