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

514.13.49 Credits and AdjustmentsThe State will account for the return of the Federal portion of all overpayments to CMS inaccordance with the applicable Federal laws and regulations.514.14 NURSE AIDE TRAINING AND REIMBURSEMENTIn accordance with CFR 483.154 (3), reimbursement is available for nursing facilities that areeligible and approved by OHFLAC to conduct nurse aid training classes in their facility. Theeducational costs for Nurse Aide training may be reimbursed to the facility where the trainingand evaluation was held at a maximum of $400 for training and $100 for competency evaluationto equal $500. Reimbursement is only available to the nursing facility after the individual hassuccessfully passed the complete competency evaluation and the training nursing facilityverifies the nurse aid has been hired as a nurse aid either at the training facility or anothernursing facility. The documentation of employment must be attached to the reimbursement form(see Appendix 3) and it must consist of a letter from the administrator at the hiring nursingfacility stating the individual has been hired as a nurse aid, along with dates of hire. Thisreimbursement is only available to a nursing facility once in a lifetime per individual Nurse Aide.514. 15 MOUNTAIN HEALTH CHOICES (MHC)Nursing home services are covered for the Traditional, Basic and Enhanced adult benefitpackages with appropriate prior authorization and approval requirements. Service coverage,prior authorization requirements, service limitations and all policy information that must befollowed as outlined in this policy.When a member is admitted to a nursing facility, the member is removed from MHC and placedin the traditional program because it is considered long term care. This occurs on the first of themonth following the admission when the member is admitted before approximately the 20th ofthe month, but no later than the 1st of the second month. Services will be covered uponadmission if the member meets all program and eligibility requirements. Inpatient rehabilitationservices provided in nursing homes are not covered separately for any adult benefit plans.Department of Health and Human Resources Chapter 514: Nursing Facility Services Page 69January 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.