Kan. Admin. Regs. § 30-10-217

Current through Register Vol. 43, No. 46, November 14, 2024

Section 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.

Kan. Admin. Regs. § 30-10-217

Authorized by and implementing K.S.A. 1995 Supp. 39-708c; effective, T-30-12-28-90, Dec. 28, 1990; effective March 4, 1991; amended Oct. 1, 1991; amended April 1, 1992; amended July 1, 1996.