Current through Register Vol. 51, No. 19, September 20, 2024
A. At the time of admission of a resident,
and whenever information changes during the resident's stay, the nursing
facility shall notify the resident and, when applicable, a representative or
interested family member, in writing and orally, in a language that is easily
understood of all terms of admission including, but not limited to the:
(1) Residents' Bill of Rights;
(2) Nursing facility's policies and
procedures that implement the Residents' Bill of Rights;
(3) Rules of resident
responsibility;
(4) Nursing
facility's complaint procedure;
(5)
Nursing facility's visitation rules;
(6) Procedures for obtaining a determination
from the Medical Assistance Program of the amount of the resident's funds
available to pay for the cost of the resident's care;
(7) Procedures for establishing eligibility
for Medicaid and for receiving refunds for previous private payments covered by
these benefits, including the right to request an assessment under
42 U.S.C. § 1396r(5)(c) for the purpose
of determining the:
(a) Extent of a couple's
nonexempt resources at the time of institutionalization, and
(b) Amount of a couple's resources to be
attributed to the community spouse as the spouse's equitable share of resources
which are not considered available for payment toward the cost of the
institutionalized spouse's medical care or for determining Medicaid eligibility
for the institutionalized spouse; and
(8) Resident's rights under State law to
formulate advance directives.
B. Upon admission of a resident, a nursing
facility shall:
(1) Document in the resident's
clinical record whether the resident has executed an advance directive and, if
an advance directive exists, keep a copy of the advance directive in:
(a) The resident's clinical record,
or
(b) A location within the
nursing facility which is accessible to appropriate administrative, nursing,
and medical personnel on a 24-hour a day basis;
(2) Prepare an inventory of all property that
the resident is bringing into the nursing facility;
(3) Request the resident or representative to
identify:
(a) Those items with a value of $100
or more,
(b) Any damage to an item
existing before admission of the resident, and
(c) Whether the resident is retaining
possession of each item or is entrusting the item to the nursing facility for
safekeeping on behalf of the resident;
(4) Give to the resident and, when
applicable, the resident's representative or interested family member, a copy
of the inventory prepared under §B(2) of this regulation; and
(5) Advise the resident and, when applicable,
a representative or interested family member:
(a) Whether the nursing facility has
purchased insurance to cover a resident's tangible personal property for loss
or damage due to the facility's negligence, and
(b) Of the limits of insurance
coverage.
C.
With information provided by the resident or representative, a nursing facility
shall periodically update the inventory of the resident's personal property
with respect to items having a value of $100 or more.
D. Required Notification. A nursing facility
shall notify in writing:
(1) A resident who is
entitled to Medicaid benefits at the time of admission, or when the resident
becomes eligible for benefits, of:
(a) Items
and services that are included in the per diem rate under Medicaid, and for
which the resident may not be charged;
(b) Other items and services that the nursing
facility offers and for which the resident may be charged, and the current
range of charges for each item and service;
(c) The nursing facility's obligation
following admission to notify the resident and, when applicable, the agent or
interested family member, of any changes made to the items and services for
which the resident may or may not be charged;
(d) The fact that the resident may not be
required to pay for an item or service not covered by Medicaid unless the:
(i) Resident or, when applicable, the agent,
knowingly requests the item or service, and
(ii) Resident receives the item or service;
and
(e) The resident's
right, within 90 days of receiving an item or service, to request an itemized
statement of charges that:
(i) Briefly and
clearly describes each item or service, the amount charged for it, and the
identity of the payer billed for the service, and
(ii) Contains a statement in bold and
conspicuous print as to when interest may be assessed consistent with
Regulation .05B(8) of this chapter;
(2) A private-pay resident, or the resident's
agent, of:
(a) The items and services included
in the nursing facility's basic per diem rate;
(b) The items and services that are covered
by Medicare, and of the amount of any copayments or deductibles;
(c) Other services that the nursing facility
offers and for which the resident may be charged, and the current range of
charges for the services, including but not limited to charges related to a
resident's monthly drug regimen review and other non-drug-related pharmacy
costs;
(d) Whether the costs for
supplies used in the performance of a service are included in the service
charge and the costs of these supplies, within 24 hours of request, when the
costs are not included in the service charge; and
(e) The resident's right, within 90 days of
receiving an item or service or within 30 days of payment, to request an
itemized statement of charges that:
(i)
Briefly and clearly describes each item or service, the amount charged for it,
and the identity of the payer billed for the service, and
(ii) Contains a statement in bold and
conspicuous print as to when interest may be assessed consistent with
Regulation .05B(8) of this chapter; and
(3) A resident of changes to be made to the
items and services specified in §D(1) and (2) of this regulation, and
increases in any fee or charge, or a new fee or charge, or a change in billing
procedures, at least 45 days before the increase, new charge, or change becomes
effective.
E. A nursing
facility shall:
(1) Give the resident a copy
of the statement of items, services, and charges provided by the
facility;
(2) Provide information
regarding services to be rendered by other health care providers, including:
(a) The cost to the resident,
(b) Transportation arrangements,
and
(c) Direct or indirect
financial interests that the nursing facility has in the provider.