8112.3 Long Term Care in Hospitals

Long term care may be provided in a distinct or separate unit of a general hospital or in a swing bed in certain general hospitals.

Swing Bed Hospital - No screening requirements exist for residents of a swing bed hospital. Eligibility for medical assistance shall be determined based on long term care procedures and guidelines for stays which exceed the time frames in 8113 , including LTC budgeting and patient liability. Appropriate level of care information must be present regardless of the length of stay.

Brain Injury Rehabilitation Facilities - All placements in a brain injury/rehab facility (BIRF) must be approved by the Independent Living Resource Counselor. A CARE assessment is not necessary. Eligibility for medical assistance shall be determined based on long term care procedures and guidelines for stays which exceed the time frames in 8113 including LTC budgeting and patient liability. Appropriate level of care information must be present regardless of the length of stay.

General Hospitals - No screening requirements exist for inpatients of a general hospital. Eligibility for medical assistance shall be determined based on long term care procedures and guidelines for stays which exceed the time frames in 8113 , including LTC budgeting. However, no patient liability is established. If countable income exceeds the income standard, Medically Needy/spenddown processes apply. Level of care information is not necessary for provider reimbursement. The institutional base period provisions of 8130 and subsections do not apply to general hospital stays. A short term stay as described in 8113 shall be budgeted as independent living with a six month base period. A long term stay shall be budgeted as institutional living with a one month base period beginning with the month after the month hospitalization began.