Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 207 - Institutional Long Term Care
Chapter 3 - Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)
Rule 23-207-3.7 - Temporary Leave Payment

Universal Citation: MS Code of Rules 23-207-3.7

Current through September 24, 2024

A. The Division of Medicaid defines temporary leave as a temporary absence for one (1) or more calendar days the resident is out of the intermediate care facility for individuals with intellectual disabilities (ICF/IID) for:

1. A home/therapeutic temporary leave.
a) The temporary leave is defined as:
1) Eight (8) consecutive hours or more during the day excluding dialysis, chemotherapy or medical treatments that occur two (2) or more days per week,

2) An absence at twelve midnight (12 a.m.), or

3) A hospital observation stay.

b) The first (1st) day of a temporary leave begins the calendar day the resident left the ICF/IID.

c) The end of the home/therapeutic temporary leave is the calendar day:
1) The resident returns to the ICF/IID,

2) After the resident returns if the resident was out of the ICF/IID for eight (8) or more hours as of midnight (12 a.m.) on the day the resident returned to the ICF/IID.

3) The resident is admitted to an inpatient hospital acute care stay from an observation stay, or

2. An inpatient hospital temporary leave.
a) The temporary leave is defined as an admission to the inpatient hospital for continuous acute care.

b) The first (1st) day of a temporary leave begins the calendar day the resident is admitted to the inpatient hospital for continuous acute care.

c) The end of the temporary leave is the calendar day the resident returns to the ICF/IID.

B. Before the resident departs on home/therapeutic or inpatient hospital temporary leave, the ICF/IID must provide a written notice to the resident and/or family member or legal representative explaining the ICF/IID's temporary leave, bed-hold and resident return policies.

1. The written notice must define the period of time during which the resident is permitted to return and resume residence in the ICF/IID.

2. The written notice must also state that if the resident's absence exceeds the Division of Medicaid's bed-hold limit the resident will be readmitted to the ICF/IID upon the first availability of a semi-private bed if the resident still requires the services provided by the ICF/IID.

C. The Division of Medicaid covers up to fifteen (15) consecutive days of home/therapeutic temporary leave per one (1) absence for up to a total of sixty-three (63) days per state fiscal year, which begins July 1 and ends June 30 of the following calendar year, in addition to certain holidays.

1. The holidays included in home/therapeutic temporary leave are:
a) Christmas Day,

b) The day before Christmas Day,

c) The day after Christmas Day,

d) Thanksgiving Day,

e) The day before Thanksgiving Day, and

f) The day after Thanksgiving Day.

2. All home/therapeutic temporary leave days must be approved by the attending physician.

3. Home/therapeutic temporary leave includes the resident's absence for:
a) Eight (8) or more consecutive hours during the day or at midnight (12 a.m.),

b) A hospital observation stay when the resident is not admitted for an inpatient hospital acute care stay, or

c) Outpatient treatments except for dialysis, chemotherapy and medical treatments that occur two (2) or more days per week.

4. The ICF/IID must reserve the resident's bed in anticipation of the resident's return and cannot fill the resident's bed with another resident during the covered period of home/therapeutic temporary leave.

5. ICF/IIDs cannot refuse to readmit a resident from home/therapeutic temporary leave if the facility has billed for home/therapeutic leave days and the resident still requires the services provided by the ICF/IID.

6. After a fifteen (15) day home/therapeutic temporary leave period has been exhausted, a new leave of absence for home/therapeutic temporary leave does not begin until the resident has returned to the ICF/IID for twenty-four (24) consecutive hours or longer.

D. The Division of Medicaid covers fifteen (15) consecutive days of inpatient hospital temporary leave per each absence for continuous acute care during an inpatient hospital stay.

1. The period of leave is determined by counting the first (1st) day of leave as the calendar day the resident was admitted to an inpatient hospital for continuous acute care after leaving the ICF/IID.

2. There is no maximum number of inpatient hospital temporary leave days per each state fiscal year.

3. Inpatient hospital temporary leave applies to acute care hospital stays in a licensed hospital including geriatric psychiatric units.

4. Inpatient hospital temporary leave does not apply if the resident is admitted for:
a) Hospital observation stays,

b) Medicare-only skilled nursing facility (SNF) stays, or

c) Swing-bed stays.

5. After a fifteen (15) day inpatient hospital temporary leave period has been exhausted, a new leave of absence for acute hospitalization does not begin until the resident has returned to the ICF/IID for a period of twenty-four (24) consecutive hours or longer.

6. ICF/IIDs cannot refuse to readmit a resident from inpatient hospital temporary leave if the facility has billed for inpatient hospital leave days and the resident still requires the services provided by the ICF/IID.

7. The ICF/IID must reserve the resident's bed in anticipation of the resident's return and cannot fill the resident's bed with another resident during the covered period of inpatient hospital temporary leave.

8. If the resident is on inpatient hospital leave and has not been discharged, the ICF/IID is responsible for providing transportation for the return to the ICF/IID.

42 C.F.R. § 447.40; Miss. Code Ann. §§ 43-13-117, 43-13-121.

Disclaimer: These regulations may not be the most recent version. Mississippi 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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