130 CMR, § 456.432

Current through Register 1533, October 25, 2024
Section 456.432 - Nonmedical Leave of Absence: Conditions for Payment
(A) For the facility to obtain payment for a nonmedical absence, the following conditions must be met.
(1) The member must request the nonmedical leave.
(2) A written authorization from the attending physician or PCP must be on file in the member's medical record.
(3) During the period of absence, the nursing facility must hold the same bed and room occupied by the member at the time the absence began and must not admit any other resident in the member's place.
(4) The member's medical record maintained by the facility must document
(a) the home address, telephone number, and relationship of the person responsible for the member while the member is absent from the facility;
(b) the duration of absence;
(c) the physician or PCP's authorization for the absence; and
(d) the member's condition before and after the absence from the facility.
(B) If the member does not return to the facility, for the purpose of payment, MassHealth considers the member to be voluntarily discharged as of the first day of unauthorized absence. The facility cannot bill MassHealth for any days of unauthorized absence. A voluntary discharge is not a discharge under 130 CMR 456.701 through 456.703 or 130 CMR 610.028: Notice Requirements Regarding Actions Initiated by a Nursing Facility through 130 CMR 610.030: Stay of a Transfer or Discharge from a Nursing Facility Pending Appeal.

130 CMR, § 456.432

Amended by Mass Register Issue 1505, eff. 10/1/2023.