TOPIC: AGREEMENTS

A hospital that has a Medicare provider agreement may provide post-hospital extended care services as specified in 42 CFR 409.20. Rural hospitals with fewer than 100 beds are allowed to use their inpatient facilities to furnish skilled nursing facility services to Medicare beneficiaries and Medicaid recipients.

Federal regulations give states the authority to claim FFP for administrative activates associated with the PASRR program included in their State Plan at Part §433.15(a)(9) of the CFR. Eligible (PASRR) activities conducted by the State may be claimed at 75%.

Adults or children who have been identified as having a Preadmission Screening and Resident Review (PASRR) disability sometimes move from a nursing facility (NF) in one state to an NF in another state. State staff members who administer PASRR programs often have questions about how such moves should be handled. For example: When does the individual need a new evaluation? And what happens if the Specialized Services an individual was receiving in State A are not available in State B? The purpose of this brief is two-fold: (1) to establish a framework for reasoning through these questions and (2) to present a series of scenarios, formulated as questions, that address situations that commonly arise.