Date
With the exception of certain hospice stays, nursing home room and board is covered under fee-for-service (FFS) regardless of whether the resident is in a Managed Care health plan. Participants who are enrolled in a Managed Care health plan, and who are seeking admission into a nursing home, will remain in a their Managed Care health plan until a nursing home level of care is determined, or for 60 calendar days, whichever comes first. MHD must have verification that a DA-124 has been issued initiating the Department of Health and Senior Services level of care review before the 60 day process can begin. For more information, refer to Provider Bulletin, Volume 45, Number 22: Nursing Home Program – Revised.