N.H. Code Admin. R. He-E 802.08

Current through Register No. 25, June 20, 2024

Section He-E 802.08 - Covered Services

(a) Pursuant to 42 CFR 483, the following services shall be covered NF services:

(1) Nursing services in accordance with 42 CFR 483.35, including:

a. Services provided to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care; and

b. Services provided on a 24-hour basis in accordance with resident care plans;

(2) Food and nutrition services in accordance with 42 CFR 483.60, including:

a. Providing each resident with a nourishing, palatable, well-balanced diet that meets the daily nutritional and special dietary needs of each resident;

b. Employing a qualified dietician either full-time, part-time, or on a consultant basis; and

c. Providing therapeutic diets, as prescribed by the attending physician;

(3) Activities program services in accordance with 42 CFR 483.24(c)(2), including an ongoing program of activities directed by a qualified professional and designed to meet, in accordance with the residents' assessments, the interests and the physical, mental, and psychosocial well-being of each resident;

(4) Medically related social services, in accordance with 42 CFR 483.40, including:

a. Services provided to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident; and

b. Employing a qualified social worker if the NF has more than 120 beds;

(5) A non-private room;

(6) The provision of routine personal generic or over the counter (OTC) hygiene items and services as required to meet the needs of residents, including, but not limited to the following:

a. Hygiene supplies;

b. Comb;

c. Brush;

d. Bath soap;

e. Disinfecting soaps or specialized cleansing agents when indicated to treat special skin problems or to fight infection;

f. Razor, and shaving cream;

g. Toothbrush, toothpaste, and dental floss;

h. Denture adhesive and denture cleaner;

i. Lotion;

j. Tissues, cotton balls, and cotton swabs;

k. Deodorant;

l. Incontinence care and supplies;

m. Sanitary napkins and related supplies;

n. Towels, washcloths, and hospital gowns;

o. Drugs;

p. Hair and nail hygiene services;

q. Bathing assistance; and

r. Basic personal laundry;

(7) Specialized rehabilitative services in accordance with 42 CFR 483.65, including, but not limited to, physical therapy, speech-language pathology, occupational therapy, respiratory therapy including oxygen, laboratory, radiology, mental health services, and those ancillary services listed in He-E 806.06, and provided by the NF or obtained by the NF from a qualified outside provider;

(8) Dental services in accordance with 42 CFR 483.55, including:

a. Providing or obtaining from an outside providers routine dental services to the extent covered by the New Hampshire Medicaid state plan pursuant to He-W 566;

b. Providing or obtaining from an outside provider emergency dental services; and

c. Assistance with:

1. Making dental appointments;

2. Arranging for transportation to and from the dentist's office; and

3. Prompt referrals to a dentist for lost or damaged dentures;

(9) Pharmacy services in accordance with 42 CFR 483.45 including:

a. Following procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals to meet the needs of each resident;

b. Medical supplies, FDA approved pharmaceutical items, and FDA approved non-legend drugs, that is, drugs prescribed by a licensed practitioner that are normally purchased OTC, which are stocked at nursing stations or on the floor in gross supply and distributed individually in small quantities to meet the needs of each resident; and

c. Pharmacy service consultation of a licensed pharmacist;

(10) Physician services in accordance with 42 CFR 483.30;

(11) Specialized services in accordance with 42 CFR 483.120 for residents with an intellectual disability or mental illness; and

(12) Behavioral health services in accordance with 42 CFR 483.40.

(b) The services in (a) above shall be covered to the extent that they are required in each resident's care plan.

N.H. Code Admin. R. He-E 802.08

#7751, eff 8-17-02, EXPIRED: 8-17-10

New. #9786, INTERIM, eff 9-20-10; ss and renumbered by #9888-A, eff 3-19-11 (formerly He-E 802.03 )

Amended by Volume XXXIX Number 16, Filed April 18, 2019, Proposed by #12741, Effective 3/20/2019, Expires 9/16/2019.

Amended by Volume XL Number 46, Filed November 12, 2020, Proposed by #13130, Effective 10/30/2020, Expires 10/29/2030.