§ 10 CCR 2505-10-8.481 - MEDICAL REVIEW/INDEPENDENT PROFESSIONAL REVIEW

  1. § 10 CCR 2505-10-8.481.1 - RESPONSIBILITY OF NURSING HOMES IN MEDICAL REVIEW PROCESS

Current through Register Vol. 44, No. 18, September 25, 2021

The Department has entered into a Memorandum of Understanding with the Colorado Foundation for Medical Care (PRO) for the conduct of medical review in skilled nursing homes and independent professional review in intermediate care facilities.

The PRO, under the terms of its agreement with the Department and with the Department of Health and Human Services, Section 1151 et seq. of the Social Security Act and the rules and regulations of the Department of Health and Human Services, shall establish procedures for the review program. Such procedures as established pursuant to the plan of review approved by the Department pursuant to the Memorandum of Understanding between the Department and the PRO shall cover the following areas of review:

A. Medicaid residents' need for admission;
B. Need for continuing care;
C. Quality of care;
D. Facility assessment of care provided in the facility;
E. Adequacy and quality of services provided; and
F. Where applicable, plans for care and rehabilitation.

The Memorandum of Understanding between the Department and the PRO is hereby incorporated by reference. The incorporation of the Memorandum of Understanding excludes later amendments to, or editions of, the referenced material. The Department maintains copies of this incorporated text in its entirety, available for public inspection during regular business hours at: Colorado Department of Health Care Policy and Financing, 1570 Grant Street, Denver, CO 80203. Certified copies of incorporated materials are provided at cost upon request.

Notes

38 CR 07, April 10, 2015, effective 5/1/2015

The following state regulations pages link to this page.



State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.