03/30/2017

ODM:Draft Patient Liability Fact Sheet

Cheryl Guyman, Nursing Facility Policy Administrator has shared with LeadingAge Ohio a draft document regarding proper application of patient liability in a NF.  The fact sheet includes the relevant OAC rules, CFR, SS for Special Income Level information as well as several scenarios for the appropriate application of PL.  The document provides guidance on how to handle PL in the following situations:

1. An individual is approved for Medicaid after they are admitted to a nursing facility (NF).
2. An individual enters NF with current Medicaid eligibility.
3. An individual enters NF with Assisted Living (AL) or Home and Community-Based Services (HCBS) waiver.
4. Transfers: NF to NF, NF to Hospice, Hospice to NF
5. Month of discharge/death when an individual is not returning to a waiver or hospital.
6. An individual covered under a Medicare Part A stay 

Questions can be directed to Cheryl Guyman at cheryl.guyman@medicaid.ohio.gov or 614-752-4709