Effective August 17, 2017 the day of readmission for an individual on a bed-hold leave is a fully reimbursable day. The Ohio Department of Medicaid (ODM) is reminding providers of the newest version of Ohio Administrative Code 5160-3-16.4 Nursing facilities (NFs): covered days and bed-hold days. The “8-hour” rule does not apply to the day that someone is readmitted. The language in the revised rule states:
(A)(8) NF occupied day" means one of the following:
(a) A day of admission or readmission.
(b) A day during which a medicaid eligible resident's stay in a NF is eight hours or more, and for which the facility receives the full per resident per day payment directly from medicaid in accordance with Chapter 5165. of the Revised Code.
(9) NF readmission" means the status of a resident who is readmitted to the same NF following a stay in a hospital to which the resident was sent to receive care, or the status of a resident who returns after a therapeutic program or visit with friends or relatives. A NF resident can only be readmitted to a facility if that individual was not officially discharged from the facility during that NF stay."