Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1181 - NURSING FACILITY CARE
Subchapter A - NURSING FACILITY CARE
PAYMENT FOR NURSING FACILITY CARE
Section 1181.61 - Services included in the interim per diem rate

Universal Citation: 55 PA Code ยง 1181.61

Current through Register Vol. 54, No. 44, November 2, 2024

The Department's interim per diem rate of reimbursement for long term care provided eligible recipients in participating facilities includes allowable costs for routine services. Services include but are not limited to:

(1) Regular room, dietary and nursing services, social services and other services required to meet certification standards, medical and surgical supplies, and the use of equipment and facilities.

(2) General nursing services, including but not limited to administration of oxygen and related medications, handfeeding, incontinency care, tray service and enemas.

(3) Items furnished routinely and relatively uniformly to all patients, such as patient gowns, water pitchers, basins and bedpans.

(4) Items furnished, distributed or used individually in small quantities such as alcohol, applicators, cotton balls, bandaids, antacids, aspirin (and other nonlegend drugs ordinarily kept on hand), suppositories and tongue depressors.

(5) Items used by individual patients but which are reusable and expected to be available, such as ice bags, bedrails, canes, crutches, walkers, wheelchairs, traction equipment and other durable medical equipment.

(6) Special dietary supplements used for tube feeding or oral feeding, such as elemental high nitrogen diet, even if written as a prescription item by a physician.

(7) Laundry services other than for personal clothing, except for intermediate care facilities for the mentally retarded in which laundry services including the laundering of resident's personal clothing are allowable.

(8) Other special medical services of a rehabilitative, restorative or maintenance nature, designed to restore or sustain the patient's physical and social capacities.

This section cited in 55 Pa. Code § 1181.52 (relating to payment conditions).

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