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They will continue at the same level of care during the appeal process.
3. The notice of the change in level of care sent by Clinical Policy at DHB to an active beneficiary outlines the correct procedure to request a reconsideration review and the time limits to make the request. Refer to the notices at the end of this section.
XVI. LONG TERM CARE OMBUDSMEN The Long Term Care Ombudsman Program is an advocacy program mandated by the Older Americans Act and the North Carolina General Statutes. Long term care ombudsmen are stationed throughout the State to assist long term care patients and their families with problems and questions related to long term care. Please refer to Adult Care Homes website, for more information on the program.
If you have a client who has a complaint about how they are being treated in a long term care facility or who needs to talk with someone about a particular long term care issue, please refer them to the long term care ombudsman who works in the county in which their facility is located.
XVII. TABLES TABLE A -- LTC RATES To be budgeted using LTC procedures: * The A/R must be institutionalized, * Have an approved FL-2 as outlined in MA-2270, and * Must be in need, as determined in Step I. MINIMUM MEDICAID REIMBURSEMENT RATES To determine the minimum Medicaid reimbursement rate (MRR) for 31 days for a skilled nursing facility, refer to V.B.1. The following is the MRR for 31 days for the facilities as listed:
ICF/IDD $12,014 Hospice Care in a NF (SNF) $6,615 Hospice Inpatient Care (Acute hospital) $16.144 ACTUAL RATES The particular facility's unique Medicaid reimbursement rate for 31 days. 1. NURSING FACILITY Verify the unique Medicaid per diem rate with the facility's business office for the approved level of nursing services.
2. HOSPITAL INAPPROPRIATE (NURSING FACILITY) LEVEL OF CARE BED All hospitals have these beds available. These rates apply to all general hospitals.
Docusign Envelope ID: 950E9248-29CC-8930-81BC-BCEC667EB493