May state that the facility will not handle monies in excess of $5,000.00.
The facility may charge a reasonable fee not to exceed the ACTUAL COST of providing service.
A statement that the facility will handle personnal funds if no other person is available.
Periodic statement of accounts (Minimum: Quarterly)
Written account of all personal funds held in trust must be sent to the executor, administrator, rep payee or next of kin within 10 DAYS OF THE DEATH OF A PATIENT.
Account must be closed and balance sent to resident within 3 DAYS OF DISCHARGE.
Money in excess of $200.00 shall be deposited in an interest bearing account within 15 days of the date the $200.00 minimum is exceeded.
MDCH also contracts with other departments and agencies to provide specific services.
The actual certifying agency is CMS. This is accomplished through the surveys and inspections.
Currently this program is 56% federally funded and 44% state funded.
Facilities MUST render covered services to ALL ELIGIBLE recipients in the same scope, quality, and manner as provided to the general public.
For covered services the facility must except the Medicaide reimbursement rate as payment in full for each and every Medicaid recipient.
The facility may not seek additional payment from residents or families for covered services.
Orders of Contracted Services (Not records) – 6 years
Process assures that residents are receiving the appropriate care at the APPROPRIATE level of care.
Abuse of Resident Trust Fund
Failure to meet the Certification Standards
Termination or suspension of Medicare automatically does the same to Medicaid
Facility is responsible for collecting
May NOT bill Medicaid for uncollected portion.
Remember facility MAY NEVER CHARGE A MEDICAID RECIPIENT MORE than the MEDICAID RATE.
Private Pay Rate: $100.00 per day
Medicaide Rate: $80.00 per day
Patient Payed: $1000.00 per day
Facility may charge for day of Admission, but not day of Discharge.
So stay = 10 days.
You must notify the local DSS office of all discharges.
Amount due from (to) resident = Amount Due – Patient Pay Amount for month
(800 – 1000 = -200)
You owe resident $200.00
Bill Medicaid 0.00
Pre-payment review for nursing need.
Hospitalization is unexpected
Return Anticipated within 10 days
Resident returns before day 10
Medicare pays in full for days 1 – 20
On Day 21, you begin to bill co-insurance (Medicaid) for day 21 – 100.
Outpatient or Medical Services
Therapies (Non Medicare A)
Billable Medical Supplies D.M.E.
Payment: Bill deductible to Medicaid
death due to or rising out of the course of employment
any injury received going to or from the workplace on the premises
where work is to be performed and within a reasonable time before and after working hours.
The “Bureau of Workers’ Compensation” and copies distributed to
The insurance carrier
The employer and
show interest must be equal to or greater than 30% of potential bargaining unit interested.
the election (NLRB Conducts; 50% plus 1 of potential bargaining unit members voting wins)
2) A patient admiitted to a home shall be examained by a licensed physician within 48hours after admission
Clinical records shall be under the supervision of a full time employee of the home
A Reliable Thermometer
General recording criteria
b) Days away from work
c) Restricted work or transfer to another job
d) Medical treatment beyond first aid
e) LOSS of consciousness
Retention and Updating
If the Building Office is Closed, May I report the incident by leaving a message on MIOSHA’s answering machine, faxing the bureau office, or sending an e-mail?
The allowable height shall not exceed 36 inches (91 cm) above the floor.
Author of Life Safety Code
Nursing Homes are required by OBRA to meet LSC
2) Transmitting alarm
3) Isolating the fire by closing doors
4) Evacuating by plan
2) Save labor
3) Assure safety
100 sq ft in private room