Statutes, codes, and regulations
California Code Of Regulations
Title 22 - Social SecurityDivision 3 - Health Care ServicesSubdivision 1 - California Medical Assistance ProgramChapter 3 - Health Care Services
Article 7 - Payment for Services and Supplies
Section 51535.1 - Bed Hold for Acute Hospitalization

Cal. Code Regs. tit. 22 § 51535.1

Download
PDF
Current through Register 2024 Notice Reg. No. 23, June 7, 2024
Section 51535.1 - Bed Hold for Acute Hospitalization
(a) Payment shall be made to skilled nursing facilities, swing bed facilities, intermediate care facilities, intermediate care facilities for the developmentally disabled, intermediate care facilities for the developmentally disabled habilitative, and intermediate care facilities for the developmentally disabled-nursing for bed hold days for any beneficiary who exercises the bed hold option provided by Title 22, California Code of Regulations, Sections 72520, 73504, 76506 and 76909.1.
(b) Payment for bed hold days shall be limited to a maximum of seven days for each period of acute hospitalization.
(c) The following requirements shall be met:
(1) Acute hospitalization for the beneficiary shall be ordered by the attending physician.
(2) The facility shall hold a bed vacant during the entire bed hold period except when notified, in writing by the attending physician that the patient requires more than seven days of hospitalization. If so notified, the facility is no longer required to hold the bed available and shall not bill Medi-Cal for any remaining days of bed hold.
(3) The day of departure shall be counted as one day of bed hold and the day of return shall be counted as one day of inpatient care.
(4) Bed hold shall be terminated and payment shall not be made on the day of death of the beneficiary.
(5) Facility claims shall identify the inclusive dates of bed hold.
(6) A new treatment authorization request shall be required, as specified in section 51335(b)(3), for Medicare-eligible beneficiaries who have returned from a Medicare-qualifying stay in an acute care hospital.
(7) The beneficiary's records maintained in the facility shall show the name and address of the acute care hospital to which the beneficiary has been admitted.
(d) Payment to skilled nursing facilities, swing bed facilities, intermediate care facilities for the developmentally disabled, intermediate care facilities for the developmentally disabled-habilitative, and intermediate care facilities for the developmentally disabled-nursing for beneficiaries who are on bed hold for acute hospitalization shall be at the appropriate facility daily rate less the amount specified in the chart below for raw food costs, except for state operated institutions.

Bed Hold Effective Rate Year

2004-052005-062006-07
$5.07$5.18$5.30

Cal. Code Regs. Tit. 22, § 51535.1

1. Amendment refiled by the Department of Health Services with the Secretary of State on 5-30-89 as an emergency pursuant to Health and Safety Code section 1275.3; operative 5-30-89. Submitted to OAL for printing only pursuant to Government Code section 11343.8 (Register 89, No. 23). For prior history, see Register 89, No. 1.
2. Amendment filed 8-7-89 as an emergency; operative 8-7-89 (Register 89, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-5-89.
3. Certificate of Compliance as to 5-30-89 order transmitted to OAL 9-27-89 and filed 10-26-89 (Register 89, No. 44).
4. Certificate of Compliance as to 8-7-89 transmitted to OAL 12-1-89 and filed 1-2-90 (Register 90, No. 2).
5. Amendment filed 12-10-90 as an emergency; operative 12-10-90 (Register 91, No. 6). A Certificate of Compliance must be transmitted to OAL by 4-9-91, or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 12-10-90 order transmitted to OAL 4-8-91 and filed 5-8-91 (Register 91, No. 24).
7. Amendment of subsection (d) and NOTE filed 8-12-91 as an emergency; operative 8-12-91 (Register 92, No. 6). A Certificate of Compliance must be transmitted to OAL 12-10-91 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 8-12-91 order transmitted to OAL 12-9-91 and filed 1-2-92 (Register 92, No. 18).
9. Amendment of subsection (d) and NOTE filed 12-3-92 as an emergency; operative 12-3-92 (Register 92, No. 49). A Certificate of Compliance must be transmitted to OAL 4-2-93 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 12-3-92 order transmitted to OAL 4-2-93 and filed 5-14-93 (Register 93, No. 20).
11. Amendment of subsection (d) and NOTE filed 8-24-93 as an emergency; operative 8-24-93 (Register 93, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-22-93 or emergency language will be repealed by operation of law on the following day.
12. Amendment of subsection (d) and NOTE refiled 12-20-93 as an emergency; operative 12-20-93 (Register 93, No. 52). A Certificate of Compliance must be transmitted to OAL by 4-21-94 or emergency language will be repealed by operation of law on the following day.
13. Certificate of Compliance as to 12-20-93 order transmitted to OAL 3-22-94 and filed 4-28-94 (Register 94, No. 17).
14. Amendment of subsection (d) and NOTE filed 8-31-94 as an emergency; operative 8-31-94 (Register 94, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-29-94 or emergency language will be repealed by operation of law on the following day.
15. Amendment of subsection (d) and NOTE refiled 1-3-95 as an emergency; operative 1-3-95 (Register 95, No. 1). A Certificate of Compliance must be transmitted to OAL 5-3-95 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 1-3-95 order transmitted to OAL 4-27-95 and filed 6-9-95 (Register 95, No. 23).
17. Amendment of section heading, subsections (b), (b)(1)-(2), (b)(7) and (d), new subsection (e) and amendment of NOTE filed 4-1-96 as an emergency; operative 4-1-96 (Register 96, No. 14). A Certificate of Compliance must be transmitted to OAL by 9-30-96 pursuant to Welfare and Institutions Code section 14132.22 or emergency language will be repealed by operation of law on the following day.
18. Editorial correction of HISTORY 17 (Register 96, No. 35).
19. Amendment of section heading, subsections (b), (b)(1)-(2), (b)(7) and (d), new subsection (e) and amendment of NOTE refiled 8-28-96 as an emergency; operative 9-30-96 (Register 96, No. 35). A Certificate of Compliance must be transmitted to OAL by 1-28-97 or emergency language will be repealed by operation of law on the following day.
20. Amendment of subsection (d) and NOTE filed 9-19-96 as an emergency; operative 9-19-96 (Register 96, No. 38). A Certificate of Compliance must be transmitted to OAL by 1-17-97 or emergency language will be repealed by operation of law on the following day.
21. Certificate of Compliance as to 9-19-96 order transmitted to OAL 1-17-97 and filed 3-3-97 (Register 97, No. 10).
22. Certificate of Compliance as to 8-28-96 order transmitted to OAL 1-23-97 and filed 3-10-97 (Register 97, No. 11).
23. Amendment of subsection (d) and NOTE filed 12-31-97 as an emergency; operative 12-31-97 (Register 98, No. 1). A Certificate of Compliance must be transmitted to OAL by 4-30-98 or emergency language will be repealed by operation of law on the following day.
24. Editorial correction of HISTORY 23 (Register 98, No. 24).
25. Certificate of Compliance as to 12-31-97 order transmitted to OAL 4-27-98 and filed 6-9-98 (Register 98, No. 24).
26. Amendment of subsection (d) and NOTE filed 10-29-98 as an emergency; operative 10-29-98 (Register 98, No. 44). A Certificate of Compliance must be transmitted to OAL by 2-26-99 or emergency language will be repealed by operation of law on the following day.
27. Certificate of Compliance as to 10-29-98 order transmitted to OAL 2-26-99 and filed 4-8-99 (Register 99, No. 15).
28. Amendment of subsection (d) and amendment of NOTE filed 11-3-99 as an emergency; operative 11-3-99 (Register 99, No. 45). A Certificate of Compliance must be transmitted to OAL by 3-2-2000 or emergency language will be repealed by operation of law on the following day.
29. Certificate of Compliance as to 11-3-99 order transmitted to OAL 3-1-2000 and filed 4-6-2000 (Register 2000, No. 14).
30. Amendment of subsection (d) and amendment of NOTE filed 11-17-2000 as an emergency; operative 11-17-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-19-2001 or emergency language will be repealed by operation of law on the following day.
31. Certificate of Compliance as to 11-17-2000 order transmitted to OAL 3-8-2001 and filed 4-19-2001 (Register 2001, No. 16).
32. Amendment of section heading, subsection (d) and NOTE filed 1-27-2003 as an emergency; operative 8-1-2001 pursuant to Statutes of 2002, Chapter 16, Items 4260-101-0001 and 4260-101-0890 (Register 2003, No. 5). A Certificate of Compliance must be transmitted to OAL by 5-27-2003 or emergency language will be repealed by operation of law on the following day.
33. Amendment of section heading, subsection (d) and NOTE refiled 5-22-2003 as an emergency; operative 5-22-2003 (Register 2003, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-19-2003 or emergency language will be repealed by operation of law on the following day.
34. Certificate of Compliance as to 5-22-2003 order transmitted to OAL 9-18-2003 and filed 10-16-2003 (Register 2003, No. 42).
35. Amendment of subsection (d) and amendment of NOTE filed 8-24-2005 as a deemed emergency pursuant to Welfare and Institutions Code section 14105(a); operative 8-24-2005 for dates of service 8-1-2002 through 7-31-2003 pursuant to Statutes of 2002, Chapter 379, Items 4260-101-0001 and 4260-101-0890 (Register 2005, No. 34). A Certificate of Compliance must be transmitted to OAL by 12-23-2005 or emergency language will be repealed by operation of law on the following day.
36. Certificate of Compliance as to 8-24-2005 order transmitted to OAL 12-22-2005 and filed 1-23-2006 (Register 2006, No. 4).
37. Change without regulatory effect amending subsections (a), (b), (c)(1)-(2) and (c)(7), repealing subsection (e) and amending NOTE filed 6-12-2006 pursuant to section 100, title 1, California Code of Regulations (Register 2006, No. 24).
38. Amendment of subsection (d) and amendment of NOTE filed 6-24-2010 as an emergency; operative 6-24-2010 (Register 2010, No. 26). A Certificate of Compliance must be transmitted to OAL by 12-21-2010 or emergency language will be repealed by operation of law on the following day.
39. Certificate of Compliance as to 6-24-2010 order transmitted to OAL 11-29-2010 and filed 1-10-2011 (Register 2011, No. 2).
40. Amendment of subsection (d) and NOTE filed 12-24-2013 as an emergency; operative 12-24-2013 (Register 2013, No. 52). A Certificate of Compliance must be transmitted to OAL by 6-23-2014 or emergency language will be repealed by operation of law on the following day.
41. Certificate of Compliance as to 12-24-2013 order transmitted to OAL 4-15-2014 and filed 5-22-2014 (Register 2014, No. 21).

Note: Authority cited: Sections 10725, 14105, 14108, 14108.1, 14108.2, 14109.5 and 14124.5, Welfare and Institutions Code; and Sections 20 and 1275.3, Health and Safety Code. Reference: Sections 14087.3, 14108, 14108.1, 14108.2, 14110.1, 14123 and 14132.22, Welfare and Institutions Code; Section 1275.3, Health and Safety Code; Statutes of 2004, Chapter 208, Items 4260-101-0001 and 4260-101-0890; Statutes of 2005, Chapter 38, Items 4260-101-0001 and 4260-101-0890; and Statutes of 2006, Chapter 48, Items 4260-101-0001 and 4260-101-0890.

1. Amendment refiled by the Department of Health Services with the Secretary of State on 5-30-89 as an emergency pursuant to Health and Safety Code section 1275.3; operative 5-30-89. Submitted to OAL for printing only pursuant to Government Code section 11343.8 (Register 89, No. 23). For prior history, see Register 89, No. 1.
2. Amendment filed 8-7-89 as an emergency; operative 8-7-89 (Register 89, No. 32). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 12-5-89.
3. Certificate of Compliance as to 5-30-89 order transmitted to OAL 9-27-89 and filed 10-26-89 (Register 89, No. 44).
4. Certificate of Compliance as to 8-7-89 transmitted to OAL 12-1-89 and filed 1-2-90 (Register 90, No. 2).
5. Amendment filed 12-10-90 as an emergency; operative 12-10-90 (Register 91, No. 6). A Certificate of Compliance must be transmitted to OAL by 4-9-91, or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 12-10-90 order transmitted to OAL 4-8-91 and filed 5-8-91 (Register 91, No. 24).
7. Amendment of subsection (d) and Note filed 8-12-91 as an emergency; operative 8-12-91 (Register 92, No. 6). A Certificate of Compliance must be transmitted to OAL 12-10-91 or emergency language will be repealed by operation of law on the following day.
8. Certificate of Compliance as to 8-12-91 order transmitted to OAL 12-9-91 and filed 1-2-92 (Register 92, No. 18).
9. Amendment of subsection (d) and Note filed 12-3-92 as an emergency; operative 12-3-92 (Register 92, No. 49). A Certificate of Compliance must be transmitted to OAL 4-2-93 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 12-3-92 order transmitted to OAL 4-2-93 and filed 5-14-93 (Register 93, No. 20).
11. Amendment of subsection (d) and Note filed 8-24-93 as an emergency; operative 8-24-93 (Register 93, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-22-93 or emergency language will be repealed by operation of law on the following day.
12. Amendment of subsection (d) and Note refiled 12-20-93 as an emergency; operative 12-20-93 (Register 93, No. 52). A Certificate of Compliance must be transmitted to OAL by 4-21-94 or emergency language will be repealed by operation of law on the following day.
13. Certificate of Compliance as to 12-20-93 order transmitted to OAL 3-22-94 and filed 4-28-94 (Register 94, No. 17).
14. Amendment of subsection (d) and Note filed 8-31-94 as an emergency; operative 8-31-94 (Register 94, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-29-94 or emergency language will be repealed by operation of law on the following day.
15. Amendment of subsection (d) and Note refiled 1-3-95 as an emergency; operative 1-3-95 (Register 95, No. 1). A Certificate of Compliance must be transmitted to OAL 5-3-95 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 1-3-95 order transmitted to OAL 4-27-95 and filed 6-9-95 (Register 95, No. 23).
17. Amendment of section heading, subsections (b), (b)(1)-(2), (b)(7) and (d), new subsection (e) and amendment of Note filed 4-1-96 as an emergency; operative 4-1-96 (Register 96, No. 14). A Certificate of Compliance must be transmitted to OAL by 9-30-96 pursuant to Welfare and Institutions Code section 14132.22 or emergency language will be repealed by operation of law on the following day.
18. Editorial correction of History 17 (Register 96, No. 35).
19. Amendment of section heading, subsections (b), (b)(1)-(2), (b)(7) and (d), new subsection (e) and amendment of Note refiled 8-28-96 as an emergency; operative 9-30-96 (Register 96, No. 35). A Certificate of Compliance must be transmitted to OAL by 1-28-97 or emergency language will be repealed by operation of law on the following day.
20. Amendment of subsection (d) and$ Note filed 9-19-96 as an emergency; operative 9-19-96 (Register 96, No. 38). A Certificate of Compliance must be transmitted to OAL by 1-17-97 or emergency language will be repealed by operation of law on the following day.
21. Certificate of Compliance as to 9-19-96 order transmitted to OAL 1-17-97 and filed 3-3-97 (Register 97, No. 10).
22. Certificate of Compliance as to 8-28-96 order transmitted to OAL 1-23-97 and filed 3-10-97 (Register 97, No. 11).
23. Amendment of subsection (d) and Note filed 12-31-97 as an emergency; operative 12-31-97 (Register 98, No. 1). A Certificate of Compliance must be transmitted to OAL by 4-30-98 or emergency language will be repealed by operation of law on the following day.
24. Editorial correction of History 23 (Register 98, No. 24).
25. Certificate of Compliance as to 12-31-97 order transmitted to OAL 4-27-98 and filed 6-9-98 (Register 98, No. 24).
26. Amendment of subsection (d) and Note filed 10-29-98 as an emergency; operative 10-29-98 (Register 98, No. 44). A Certificate of Compliance must be transmitted to OAL by 2-26-99 or emergency language will be repealed by operation of law on the following day.
27. Certificate of Compliance as to 10-29-98 order transmitted to OAL 2-26-99 and filed 4-8-99 (Register 99, No. 15).
28. Amendment of subsection (d) and amendment of Note filed 11-3-99 as an emergency; operative 11-3-99 (Register 99, No. 45). A Certificate of Compliance must be transmitted to OAL by 3-2-2000 or emergency language will be repealed by operation of law on the following day.
29. Certificate of Compliance as to 11-3-99 order transmitted to OAL 3-1-2000 and filed 4-6-2000 (Register 2000, No. 14).
30. Amendment of subsection (d) and amendment of Note filed 11-17-2000 as an emergency; operative 11-17-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-19-2001 or emergency language will be repealed by operation of law on the following day.
31. Certificate of Compliance as to 11-17-2000 order transmitted to OAL 3-8-2001 and filed 4-19-2001 (Register 2001, No. 16).
32. Amendment of section heading, subsection (d) and Note filed 1-27-2003 as an emergency; operative 8-1-2001 pursuant to Statutes of 2002, Chapter 16, Items 4260-101-0001 and 4260-101-0890 (Register 2003, No. 5). A Certificate of Compliance must be transmitted to OAL by 5-27-2003 or emergency language will be repealed by operation of law on the following day.
33. Amendment of section heading, subsection (d) and Note refiled 5-22-2003 as an emergency; operative 5-22-2003 (Register 2003, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-19-2003 or emergency language will be repealed by operation of law on the following day.
34. Certificate of Compliance as to 5-22-2003 order transmitted to OAL 9-18-2003 and filed 10-16-2003 (Register 2003, No. 42).
35. Amendment of subsection (d) and amendment of Note filed 8-24-2005 as a deemed emergency pursuant to Welfare and Institutions Code section 14105(a); operative 8-24-2005 for dates of service 8-1-2002 through 7-31-2003 pursuant to Statutes of 2002, Chapter 379, Items 4260-101-0001 and 4260-101-0890 (Register 2005, No. 34). A Certificate of Compliance must be transmitted to OAL by 12-23-2005 or emergency language will be repealed by operation of law on the following day.
36. Certificate of Compliance as to 8-24-2005 order transmitted to OAL 12-22-2005 and filed 1-23-2006 (Register 2006, No. 4).
37. Change without regulatory effect amending subsections (a), (b), (c)(1)-(2) and (c)(7), repealing subsection (e) and amending Note filed 6-12-2006 pursuant to section 100, title 1, California Code of Regulations (Register 2006, No. 24).
38. Amendment of subsection (d) and amendment of Note filed 6-24-2010 as an emergency; operative 6-24-2010 (Register 2010, No. 26). A Certificate of Compliance must be transmitted to OAL by 12-21-2010 or emergency language will be repealed by operation of law on the following day.
39. Certificate of Compliance as to 6-24-2010 order transmitted to OAL 11-29-2010 and filed 1-10-2011 (Register 2011, No. 2).
40. Amendment of subsection (d) and Note filed 12-24-2013 as an emergency; operative 12-24-2013 (Register 2013, No. 52). A Certificate of Compliance must be transmitted to OAL by 6-23-2014 or emergency language will be repealed by operation of law on the following day.
41. Certificate of Compliance as to 12-24-2013 order transmitted to OAL 4-15-2014 and filed 5/22/2014 (Register 2014, No. 21).