Chapter 514 - Nursing Facility Services - DHHR - State of West ...

Waiver of this 30-day requirement may be appropriate if the safety of individuals in the facilitywould be endangered, the immediate transfer is required by the resident’s urgent medicalneeds, or a resident has not resided in the nursing facility for 30 days.The written notice must include the following:The effective date of the transfer or discharge;Reason for the discharge;The location or person(s) to whom the resident is transferred or discharged;A statement that the resident has the right to appeal the action to the State Board ofReview, during this time of appeal, the resident/member may choose to stay in the facility;The name, address and telephone number of the State long term care ombudsman;The mailing address and telephone number of the agency responsible for the protectionand advocacy of developmentally disabled and mentally ill individuals.It is the responsibility of the nursing facility to notify the local WVDHHR office when a Medicaidmember is admitted to the facility and when a member discharges from the facility in order forthe facility and member to receive the appropriate Medicaid benefit.514.9.3 Bed ReservationA nursing facility may receive Medicaid per diem reimbursement to reserve a resident’s bed(bed hold) during his/her temporary absence from the facility. This is paid at the facility’sestablished Medicaid base rate.The facility’s occupancy must be 95% or greater as of midnight on the day immediately beforethe time that the resident leaves and there must be a current waiting list for admission to thenursing facility. The midnight census must be obtained daily and kept either in hard copy orelectronic format and must contain, at a minimum, the names and ID numbers for each resident.A waiting list for admission must be maintained either in hard copy or electronic format by dayand must contain, at a minimum, the names, addresses and contact numbers of the individualson the waiting list and must be available immediately upon request by the Department.A day of leave is defined as a continuous 24-hour period. At the time the resident leaves thefacility, the primary payer for services must be Medicaid. Bed reservation days may be foracute care hospitalization or a therapeutic leave.The resident whose bed is reserved is to be accepted by the facility immediately upon dischargefrom the hospital or return from therapeutic leave. Placement is to be in the same bed andliving space occupied by the resident prior to the hospital or therapeutic leave of absence unlessDepartment of Health and Human Resources Chapter 514: Nursing Facility Services Page 43January 1, 2013DISCLAIMER: This manual does not address all the complexities of Medicaid policies and procedures,and must be supplemented with all State and Federal Laws and Regulations.