Author: Clinical Policy, Long Term Services and Supports
Effective Oct. 1, 2017, Clinical Coverage Policy 2B-1, Nursing Facility Services, was revised in accordance with 42 CFR 483 Subpart B. The following sections have been updated:
Non-Covered Patient Care Items and Services
- Transfer and Discharge
- Readmissions
- Conditions of Participation
- Payments for Services
- Married Residents
- Personal Funds
- Request for Items and Services
- Private Rooms
- Attachment L: Nursing Facility Quality Initiatives
In addition, prior approval (PA) requirements are updated to comply with the current PA process and quality improvement initiatives now require the completion of a resident satisfaction survey. The revisions also update the requirements for a significant change referral for Preadmission Screening and Resident Review (PASRR) and the requirements of the Nursing Facility Transitions Program.
The appeals process language, which was inadvertently removed from Section 4.28 of the North Carolina State Plan, was replaced.
Clinical Policy, Long Term Services and Supports
DMA, 919-855-4378