Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1181 - NURSING FACILITY CARE
Subchapter A - NURSING FACILITY CARE
PROVIDER PARTICIPATION
Section 1181.42 - Additional participation requirements for hospital-based nursing units

Universal Citation: 55 PA Code ยง 1181.42

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

In addition to the participation requirements listed in §§ 1181.41 and 1181.45 (relating to provider participation requirements; and ongoing responsibilities of providers), hospital-based nursing units shall meet the following requirements:

(1) The nursing unit shall be composed of former acute care hospital beds that have been converted to and certified for skilled nursing or intermediate care.

(2) The need for the beds shall have been approved by the local health planning agency.

(3) The distinct part unit may not exceed 50% of the facility's total licensed or approved bed complement for acute hospital care. A facility will, however, be granted an exception to the 50% bed limit if it submits written documentation to the Office of MA, Bureau of Long Term Care Programs, substantiating that all of the following criteria have been met:

(i) Beds operated in excess of the 50% limit have been approved by the Department of Health, Division of Need Review.

(ii) The unit is located in an area underserved or lacking long term care beds under an approved local health plan.

(iii) More than 50% of the unit's licensed long term care beds are occupied by MA patients.

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