101 CMR 206.07 - Payments for Individuals in a Disaster Struck Nursing Facility
(1) Payment to a Disaster Struck Nursing
Facility for individuals that must be temporarily evacuated to another facility
(Resident Accepting Nursing Facility) may continue for up to 30 days after the
disaster event.
(2) Payment will be
the same as if the individual was residing in the Disaster Struck Nursing
Facility. No other payment will be made to either the Disaster Struck Nursing
Facility or the Resident Accepting Nursing Facility for evacuated individuals.
The Disaster Struck Nursing Facility must meet the following conditions in
order to receive payment for evacuated individuals:
(a) The Disaster Struck Nursing Facility must
have a contract with the Resident Accepting Nursing Facility. The contract must
include:
1. terms of payment and mechanisms
to resolve any contract disputes;
2. protocols for sharing care and treatment
information between the two facilities; and
3. requirements that both facilities meet all
conditions of Medicaid participation, as determined by the MassHealth
agency.
(b) The Disaster
Struck Nursing Facility must notify the MassHealth agency of the disaster
event, maintain records of all evacuated individuals that include each
individual's name, date of evacuation, and Resident Accepting Nursing Facility,
and update the MassHealth agency on the status of any necessary
repairs.
(c) The Disaster Struck
Nursing Facility must determine within 15 days of the disaster event whether
evacuated individuals will be able to return to the facility within 30 days of
the disaster event. If the Disaster Struck Nursing Facility determines that it
is not able to reopen within 30 days, it must discharge all evacuated
individuals and work with them to choose admission to other facilities or
alternative placements. Nothing precludes an evacuated individual from asking
to be discharged and admitted to another facility or alternative placement.
Payment to the Disaster Struck Nursing Facility will cease when an individual
is discharged from the facility.
Notes
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.
(1) Payment to a Disaster Struck Nursing Facility for individuals that must be temporarily evacuated to another facility (Resident Accepting Nursing Facility) may continue for up to 30 days after the disaster event.
(2) Payment will be the same as if the individual was residing in the Disaster Struck Nursing Facility. No other payment will be made to either the Disaster Struck Nursing Facility or the Resident Accepting Nursing Facility for evacuated individuals. The Disaster Struck Nursing Facility must meet the following conditions in order to receive payment for evacuated individuals:
(a) The Disaster Struck Nursing Facility must have a contract with the Resident Accepting Nursing Facility. The contract must include:
1. terms of payment and mechanisms to resolve any contract disputes;
2. protocols for sharing care and treatment information between the two facilities; and
3. requirements that both facilities meet all conditions of Medicaid participation, as determined by the MassHealth agency.
(b) The Disaster Struck Nursing Facility must notify the MassHealth agency of the disaster event, maintain records of all evacuated individuals that include each individual's name, date of evacuation, and Resident Accepting Nursing Facility, and update the MassHealth agency on the status of any necessary repairs.
(c) The Disaster Struck Nursing Facility must determine within 15 days of the disaster event whether evacuated individuals will be able to return to the facility within 30 days of the disaster event. If the Disaster Struck Nursing Facility determines that it is not able to reopen within 30 days, it must discharge all evacuated individuals and work with them to choose admission to other facilities or alternative placements. Nothing precludes an evacuated individual from asking to be discharged and admitted to another facility or alternative placement. Payment to the Disaster Struck Nursing Facility will cease when an individual is discharged from the facility.