Nursing Facility

Nursing Facility

Coronavirus Disease 2019 (COVID-19) Testing

In response to circumstances surrounding COVID-19, the South Carolina Department of Health and Human Services (SCDHHS) is announcing additional testing resources available to healthcare personnel within South Carolina Healthy Connections Medicaid-enrolled nursing facilities beginning Jan. 1, 2021. The testing resources will help offset the unexpected cost of COVID-19 testing for nursing facilities and are being made available through a partnership with the Medical University of South Carolina’s Medical University Hospital Authority (MUHA).

Update on COVID-19 Regulatory and Reimbursement Flexibilities for Nursing Facilities

On April 30, 2020, the South Carolina Department of Health and Human Services (SCDHHS) issued a Medicaid Alert announcing it was granting certain temporary regulatory flexibilities related to admissions to skilled nursing facilities and participation in the Medicaid nursing home program.

COVID-19 Level of Care and Notice of Admission, Authorization and Change of Status for Long Term Care (SCDHHS Form 181) Guidance

The South Carolina Department of Health and Human Services (SCDHHS) has announced updated guidance for providers in nursing facilities, swing bed facilities and intermediate care facilities for individuals with intellectual disabilities.

COVID-19 Regulatory and Reimbursement Flexibilities for Nursing Facilities

On Friday, March 13, 2020, President Donald Trump declared a national emergency due to coronavirus disease 2019 (COVID-19) and Governor Henry McMaster declared a state of emergency for the state of South Carolina. As a part of the state’s preparation and response to COVID-19, the South Carolina Department of Health and Human Services (SCDHHS) is announcing additional temporary modifications to policies related to admissions to skilled nursing facilities and participation in the Medicaid nursing home program.

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.

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