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Elizabeth M. Whitehorn, Director

Provider Notice Issued 06/14/2018

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Date:  June 14, 2018                                                

 

To:     Long Term Care providers - Nursing Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Specialized Mental Health Rehabilitation Facilities, State Operated Facilities and Supportive Living Program

 

Re:     Reporting Resident Discharges or Death through MEDI

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This notice serves as a reminder to Long Term Care (LTC) providers of the need to report the death of a resident or discharge of a resident who leaves the facility and does not intend to return, electronically through the Medical Electronic Data Interchange (MEDI) or Electronic Data Interchange (formerly referred to as REV).

 

A death or discharge transaction cannot be entered through the MEDI or EDI system until the Department of Human Services (DHS) has processed the approval of a resident’s admission transaction. The Transaction Report sent to the LTC provider serves as notification of a processed admission. Providers may also verify a resident’s admission status by performing an LTC Inquiry through MEDI.

 

LTC providers are required to submit resident death or discharge within 15 calendar days. This reporting requirement does not include a bed reserve period in which a resident is temporarily absent and intends to return (e.g. hospitalization or home visit).

 

Failure to report a resident’s discharge or death can negatively affect the facility Medicaid per diem. A resident will be assigned a “default” rate when the LTC provider identifies a resident of that facility in Healthcare and Family Services data systems and there is no corresponding OBRA Minimum Data Set (MDS) assessment for that calendar quarter.  The MDS is used to set the Nursing component of a facility’s Medicaid per diem.

 

Failure to report a resident discharge will also cause that resident to be unable to obtain services and items that were provided as part of the facility’s Medicaid per diem (e.g. durable medical equipment or incontinence supplies) after they leave the facility.

 

If you have questions, contact the Bureau of Long Term Care toll-free at 844-528-8444.

 

Felicia F. Norwood

Director