Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 140 - Medicaid Coverage; Facility and Facility-Based Services
Article 7 - Nursing Facility Services: ICF and SNF
7 AAC 140.505 - Authorization for admission and determination of level of care

Universal Citation: 7 AK Admin Code 140.505

Current through November 28, 2024

(a) The department will authorize an individual for nursing facility services as a new admission, transfer, or continuing placement. Authorization may be given even if an individual is currently receiving services in a general acute care hospital or in an inpatient psychiatric hospital, or nonacute care services in a skilled nursing facility, an intermediate care facility, a home, or other nonacute setting. The department will determine the appropriate level of care by considering

(1) the type of care required;

(2) the qualifications of the person necessary to provide direct care; and

(3) whether the recipient's overall condition is relatively stable or unstable.

(b) To receive payment under 7 AAC 105 - 7 AAC 160, a nursing facility, on a form provided by the department, must request

(1) the authorization for admission of the recipient:

(2) a level-of-care determination; and

(3) a length-of-stay determination.

(c) When requesting authorization or reauthorization for admission and a level-of-care determination, a provider shall provide the following information:

(1) the medical reason for the stay or continued stay;

(2) information supporting the level-of-care decision of the facility's utilization review committee;

(3) the plan of care established for the recipient by the attending physician;

(4) the recipient's diagnosis, symptoms, complaints, and any complication indicating the need for admission or continued stay;

(5) a description of the functional level of the recipient;

(6) written objectives;

(7) an order for medications, treatments, restorative and habilitative services, therapies, diet, activities, social services, and special procedures to meet these objectives;

(8) the plans for continuing care, including provision for review and necessary modification of the plan;

(9) the reasons why alternative placement is not feasible or appropriate;

(10) the plan for discharge.

Authority:AS 47.05.010

AS 47.07.030

AS 47.07.040

Disclaimer: These regulations may not be the most recent version. Alaska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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