WAG 20-08-14.

Do not approve payment for care in a private Revised textNH or SLF unless the FCRC receives Revised textall necessary information for the customer.  The facility uses MEDI or REV to enter the data which was formerly provided by completing a Report on Resident of Private LTC Facility (Form 26). The information required is in addition to the screening requirement. This is not required for anyone who was readmitted to the same facility after a hospital stay of 10 days or less.

Supportive Living Facilities

SLFs are paid for services, using a per diem rate. The per diem rate paid to an SLF is negotiated with HFS for services described in the contract between the SLF and HFS.

Nursing Homes

Revised textNursing homes are paid for services, using a per diem rate. For out-of-state facilities, payment is negotiated based on the intensity of the services required.

DHS is paid a per diem rate for customers in DHS facilities. The rate includes room and board, medical treatment, and social services. Payment is made by interdepartmental tape exchanges. DHS submits the tapes to the Bureau of Information Services, Springfield. Tapes are not submitted to the FCRC.

Revised textNursing homes provide the following at no extra charge:

  • Room and board, supervision and oversight, laundry, and housekeeping services;
  • Food and food substitutes and supplements;
  • All staff, equipment, and supplies required to provide the services needed by customers. See PM 20-12-01 for payment for therapy services provided by an independent therapist;

    NOTE: This provision only includes one tank of oxygen per month per resident. See PM 20-18-02-b for payment for additional tanks. 

  • Services to meet all the requirements of DPH;
  • Medications available without prescription that DPH permits the facility to stock. Examples include cough syrups, laxatives, and analgesics;
  • Over-the-counter drugs or items ordered by a physician;
  • For residents of ICF/MR facilities, all routine and preventive dental services.

Each facility's per diem rate consists of separate components. Each of the components is paid at an approved rate.