Kan. Admin. Regs. § 30-10-217 - ICF-MR reserve days
(a) Payment shall
be available for days for which it is necessary to reserve a bed in an
intermediate care facility for the mentally retarded when the client is absent
for:
(1) admission to a hospital for acute
conditions;
(2) therapeutically
indicated home visits with relatives or friends; or
(3) participation in state-approved
therapeutic or rehabilitative programs.
(b)
(1)
Payment shall be available only for the days during which there is a likelihood
that the reserved bed would otherwise be required for occupancy by some other
client.
(c) The
provider shall notify the local agency office before routine absence from the
facility by clients in the Kansas medicaid/medikan program. In case of
emergency admission to a hospital, the provider shall notify the local agency
office not later than five working days following admission.
(d) In order for payment to be available, the
following conditions shall be met when a bed is reserved in an ICF/MR because
of hospitalization.
(1) The provider shall be
reimbursed for client reserve days for hospitalization of an acute condition
for each period of hospitalization up to 10 days.
(2) ICF/MR clients transferred to one of the
state mental retardation facilities, shall be eligible for 21 hospital reserve
days.
(3) The client shall intend
to return to the same facility after the hospitalization and the facility shall
intend to accept the individual for service.
(4) The hospital shall provide a discharge
plan for the client which includes returning to the facility requesting the
reserve days.
(5) An ICF/MR which
has less than 90 percent occupancy shall not be approved for hospitalization
reserve days.
(e) The
client's plan of care shall provide for any non-hospital related absence.
Payment for non-hospital related reserve days for eligible clients residing in
intermediate care facilities for the mentally retarded shall not exceed 21 days
per calendar year, including travel. If additional days are required to
alleviate a severe hardship or facilitate normalization, the ICF-MR provider
shall send the request for additional days and supporting documentation to the
agency for approval or disapproval.
(f) This regulation shall not prohibit any
client from leaving a facility if the client so desires.
(g) Payments made for unauthorized reserve
days shall be reclaimed by the agency.
(h) This regulation shall take effect on and
after July 1, 1996.
Notes
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