Section 29-950. PAYMENT FOR RESERVED BEDS

 

950.1Vendor payment for reserved bed days for hospitalization or therapeutic leaves of absence, for a resident of a nursing facility, when provided in the resident's plan of care, shall not exceed eighteen (18) days during any fiscal year, if there is a reasonable expectation that the resident will return to the nursing facility.

 

950.2Vendor payment for reserved bed days for hospitalization, for a resident of an intermediate care facility for persons with mental retardation (ICFs/MR) shall not exceed fifteen (15) days during any fiscal year, if there is a reasonable expectation that the resident will return to the facility.

 

950.3Vendor payment for reserved bed days for therapeutic leaves of absence, for a resident of an ICF/MR, when provided in the resident's plan of care shall not exceed forty-five (45) days during any fiscal year, if there is a reasonable expectation that the resident will return to the facility.

 

950.4Payment for reserved bed days authorized in accordance with section 950.1 shall equal 100 percent of the facility's per diem rate.

 

950.5Payment for reserved bed days authorized in accordance with sections 950.2 and 950.3 shall equal the facility's per diem rate and shall not include reimbursement for one to one services. A reserved bed day for purposes of this section is a day in which an ICF/MR resident receives fewer than eight of hours of supports in an ICF/MR beginning at midnight (12:00 am) and ending at 11:59 p.m.

 

950.6Each resident shall reside in the nursing facility or ICF/MR for at least one day as a condition of vendor payment for reserved bed days.

 

950.7Each provider shall require the family member or caregiver to sign a leave and request form upon exit and return to the facility. The provider shall ensure that each family member or caregiver provide contact information.

 

950.8Each provider shall discuss the resident's medical regimen with the family member or caregiver. The provider shall ensure that each family member or caregiver is provided a sufficient quantity of the resident's medication for the leave period.

 

950.9Each provider shall report to MAA any unusual incident that occurred during any therapeutic leave of absence.

 

 

authority

An Act to enable the District of Columbia to receive Federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.2)); Reorganization Plan No. 4 of 1996, effective January 13, 1997; and Mayor's Order 97-42, dated February 18, 1997.

source

Final Rulemaking published at 53 DCR 1370 (February 24, 2006); as Final Rulemaking published at 54 DCR 3879 (April 27, 2007).