(Refer to Table A for reimbursement rates.)
There are two types of hospital beds for LTC care. These are: (1) inappropriate level of care bed; and (2) swing bed. Sometimes when patient is ready to be discharged to ltc, there is no available ltc bed. A hospital may continue to provide care for patients who are approved for LTC, pending discharge to a facility. This care is provided in an inappropriate level of care bed or swing bed.
REVISED 11/01/07 – CHANGE NOTICE 25-07
If the patient moves from a general hospital stay of less than 30 days directly to an inappropriate level of care bed or a swing bed, the patient became institutionalized on the first day of the hospital admission. (See II.A.l.b., above)
The hospital is responsible for completing the FL-2 and sending it to the claims processing contractor for prior approval.
When a LTC facility fails to meet standards of patient care, the Centers for Medicare and Medicaid Services/Division of Health Service Regulation (DHSR) terminates the Medicaid certification. DHSR may also revoke the facility's license.
NOTE: Timely notice requirements apply. Notice should be sent in time to affect the deductible the month following the last month of Medicaid payment.
REISSUED 11/01/07 – CHANGE NOTICE 25-07
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.