Haw. Code R. § 17-1739-73 - Wait listed reimbursements

(a) Payments for wait listed patients shall reflect the level of care required by the patient. The facility shall receive a routine per diem for each day that a wait listed patient remains in the acute care part of the facility. Room and board wait listed rates are to be determined based upon the statewide weighted average costs of providing either SNF or ICF services by distinct part facilities per the medicaid long-term care prospective payment rate calculations with the following exceptions:

(1) The wait listed rates cannot exceed the facility's own distinct part SNF or ICF prospective payment rates;

(2) A facility with a distinct part SNF, but no ICF, would have an ICF wait listed rate based on the statewide weighted average but not to exceed the facility's distinct SNF prospective payment rate; and

(3) In no case will any relief granted under rate reconsideration be used to adjust the wait listed rates.

(b) Wait listed rates shall be annually adjusted by the same inflation factors as the long-term care PPS rates.

(c) The rate for wait listed long-term care patients in acute care beds does not include ancillary services except for medical supplies and maintenance therapy. These excluded ancillary services must therefore be billed separately. Reimbursements will be consistent with the ancillary rates paid to long term care facilities.

Notes

Haw. Code R. § 17-1739-73

[Eff 11/13/95] (Auth: HRS § 346-59) (Imp: 42 C.F.R. §447.252)