Section 435.424 - Medical Leave of Absence: Responsibilities of the Hospital for the Transfer of a Member Who is a Resident of a Nursing Facility(A) The Division will pay a nursing facility to reserve a bed during a member's medical leave of absence if the admitting hospital meets the requirements of 130 CMR 435.424(B).(B) Whenever a member is admitted to a hospital from a nursing facility, the hospital must comply with the following requirements.(1) The hospital must ensure that the Division's nursing facility bed reservation form for medical leave of absence (hereafter referred to as "the bed reservation form") has been received from the nursing facility.(2) Not later than the second working day of the member's hospital stay, the hospital must: (a) review the member's medical record to determine the member's estimated length of stay;(b) notify the nursing facility by telephone of the estimated number of days of the stay and document in the member's medical record the date of such telephone notification to the nursing facility; and(c) complete the appropriate section of the bed reservation form, according to the instructions provided on the form.(3) When the member's estimated length of stay will be ten consecutive days or less, the facility must reserve a bed for the same number of days and the hospital must so notify its discharge-planning unit.(4) When the member's estimated length of stay exceeds ten consecutive days, the facility must not reserve a bed and the hospital must so notify its discharge-planning unit. (C) The hospital must review the member's medical status on an ongoing basis. Whenever a change in the member's medical status occurs before the tenth day of the hospital stay, the hospital must: (1) review the member's medical record;(2) revise the estimated length of stay if the member's change in medical status so requires;(3) immediately notify the nursing facility by telephone of the revised estimated length of stay, in accordance with 130 CMR 435.424(B); and(4) complete the appropriate section of the bed reservation form, if applicable, according to the instructions provided on the form. (D) If the member is transferred within the ten-day medical leave-of-absence period to another hospital: (1) the transferring hospital must: (a) notify the nursing facility immediately by telephone; and(b) complete the appropriate section of the bed reservation form, according to the instructions provided on the form; and(2) the receiving hospital must comply with all the requirements stated in 130 CMR 435.424. (E) If the member is transferred within the ten-day medical leave-of-absence period to another nursing facility or noninstitutional setting, or if the member dies, the hospital must: (1) notify the original nursing facility immediately by telephone; and(2) complete the appropriate section of the bed reservation form according to the instructions provided on the form. (F) Failure by the hospital to comply with any of the requirements set forth in 130 CMR 435.424 may result in administrative fines in accordance with the Division's administrative and billing regulations at 130 CMR 450.237: Overpayments: Determination and 450.238: Sanctions: General.Amended by Mass Register Issue 1302, eff. 12/18/2015.