Nursing Facility

Nursing Facility

October 2017 Nursing Facility Provider Trainings

The South Carolina Department of Health and Human Services (SCDHHS) Division of Community and Facility Services will host three regional trainings on policy updates, billing and reimbursement for nursing facility providers. These trainings, scheduled in October, are for any nursing facility provider that is enrolled in the South Carolina Medicaid program through SCDHHS.

Provider training is scheduled from 9:30 a.m.-1 p.m. Oct. 11 in Columbia, Oct. 17 in Charleston and Oct. 25 in Greenville, S.C. Training details, including the logistics for each location, are attached.

Estate Recovery

Effective October 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) Estate Recovery Department will increase the minimum estate asset value upon which SCDHHS can file claims to $25,000 or more. Currently, SCDHHS files claims against estates with assets valued at $10,000 or more. SCDHHS has determined that it is not cost effective to pursue estates with total assets of less than $25,000 after all priority expenses (funeral, attorney fees, etc.), have been paid.

Inpatient Psychiatric Coverage for beneficiaries 65 or older

Effective for services provided on or after July 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will allow for coverage of inpatient psychiatric care for beneficiaries of Medicare and Medicaid who are 65 or older.

Increase in Hours for Nurse Aide Training & Programs New Timeframe Policy for Nurse Aide Program Testing

 

South Carolina Department of Health and Human Services (SCDHHS) will be making important changes to the South Carolina State-approved Nurse Aide Training Program (NATP) requirements. These changes will be effective as of July 1, 2013.

Referrals to Community Long Term Care (CLTC)

 

ffective January 7, 2013, the Division of Community Long Term Care (CLTC) will centralize intake activities for all programs operated by CLTC.  This includes referrals for nursing home placement, nursing home conversion, Pre-Admission Screening Resident Review (PASRR), home and community based waiver services, children’s personal care and nursing services, and Katie Beckett Medicaid Program (TEFRA).  When intake activities are centralized, referrals will no longer be accepted at the CLTC Regional Offices.  Referrals will only be accepted by one of the methods below.

ADDITIONAL SERVICES PERFORMED BY KEPRO

 

Effective with dates of service on or after October 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will require prior authorization (PA) for the following services and medical record pre-payment review from our Quality Improvement Organization (QIO), KePRO.

Home Again Program Implementation

 

The South Carolina Department of Health and Human Services (SCDHHS) will implement the Home Again program beginning September 1, 2012.  Home Again is part of the national initiative called The Money Follows the Person Rebalancing Demonstration Program administered by the Centers for Medicare and Medicaid Services (CMS). 

 

  1. The Purpose of the Home Again Program

 

A. Nursing Facility Bed Locator B. Complex Care Program

 

The South Carolina Department of Health and Human Services (SCDHHS) will sponsor four regional trainings to introduce two new initiatives, the Nursing Facility Bed Locator (NFBL) and the Complex Care Program (CCP).

 

A.         Nursing Facility Bed Locator

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