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37.86.2921    HOSPITAL RESIDENCY STATUS

(1) A recipient who is unable to be cared for in a setting other than the acute care hospital is eligible for hospital residency status.

(2) To obtain hospital residency status, the recipient must meet the following requirements:

(a) the recipient must utilize a ventilator for a continuous period of not less than eight hours in a 24-hour period or require at least 10 hours of direct nursing care in a 24-hour period; and

(b) the recipient must have been an inpatient in an inpatient hospital for a minimum of six continuous months.

(3) The provider will have the responsibility of determining whether services could be provided in a skilled nursing care facility or by the home and community based waiver program to a Medicaid recipient within the state of Montana.

(4) The provider shall maintain written records of inquiries and responses about the present and future availability of openings in nursing homes and the home and community based waiver program.

(5) A redetermination of nursing home or waiver availability must be made at least every six months.

History: 2-4-201, 53-2-201, 53-6-113, MCA; IMP, 2-4-201, 53-2-201, 53-6-101, 53-6-111, 53-6-113, 53-6-149, MCA; NEW, 2004 MAR p. 482, Eff. 2/27/04.

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