Kan. Admin. Regs. § 30-10-21
Current through Register Vol. 43, No. 46, November 14, 2024
Section 30-10-21 - Reserve days(a) Payment shall be available for nursing facility residents, excluding those on planned temporary stays, for days for which it is necessary to reserve a bed in a nursing facility (NF) or nursing facility for mental health (NF-MH) when the resident is absent for any of the following reasons: (1) Admission to a hospital for acute conditions; (2) therapeutically indicated home visits with relatives and friends; or (3) participation in any state-approved therapeutic or rehabilitative program. (b) In order for payment to be available, the following requirements shall be met when a bed is reserved in a nursing facility or nursing facility for mental health because of a resident's hospitalization for acute conditions: (1) The period of hospitalization shall not exceed either of the following limits: (A) 10 days for each single hospital stay for an acute condition; or (B) 21 days for residents from a nursing facility for mental health for each admission to a state mental institution or admission to a psychiatric ward in any of the following: (ii) a private psychiatric hospital; or (iii) a veterans administration medical center. (2) The resident shall intend to return to the same facility after hospitalization. (3) The hospital shall provide a discharge plan for the resident. (4) Reimbursement shall not be made to reserve a bed in a swing bed hospital if a nursing facility will be reimbursed for the same day to reserve a bed for the resident's return from the hospital. (c) The resident's plan of care shall provide for the non-hospital-related absence. (1) Payment for non-hospital-related reserve days for eligible residents in nursing facilities for mental health shall not exceed 21 days per calendar year, including travel. If additional days are required to obtain or retain employment, participate in a job readiness training program, or alleviate a severe hardship, the requesting party shall send a request for additional days and supporting documentation to the fiscal agent for approval or disapproval. (2) Payment for non-hospital-related reserve days for all eligible residents in nursing facilities shall not exceed 18 days per calendar year, including travel. If additional days are required to alleviate a severe hardship, the requesting party shall send a request for additional days and supporting documentation to the fiscal agent for approval or disapproval. (d) This regulation shall not prohibit any resident from leaving a facility if the resident so desires. (e) Payments made for unauthorized reserve days shall be reclaimed by the agency. (f)(1) Before any routine absence by residents, the provider shall notify the local agency office. (2) In case of emergency admission to a hospital, the provider shall notify the local agency office not later than five working days following admission. (g) Payment for reserve days shall be approved except when the absence is longer than 10 hospital days for NF or NF-MH residents or 21 hospital days for NF-MH residents who enter either of the following: (1) A state mental hospital; or (2) a psychiatric ward in any of the following: (B) a private psychiatric hospital; or (C) a veterans administration medical center. Kan. Admin. Regs. § 30-10-21
Authorized by and implementing K.S.A. 39-708c; effective May 1, 1985; amended May 1, 1986; amended May 1, 1987; amended May 1, 1988; amended Jan. 2, 1989; amended Jan. 2, 1990; amended, T-30-3-29-90, April 1, 1990; amended, T-30-10-1-90, Oct. 1, 1990; amended Jan. 30, 1991; amended July 1, 1996; amended Oct. 1, 2000; amended July 1, 2002; amended Aug. 15, 2003.