- (1) Payments to nursing facilities may be made for therapeutic leave visits to home, relatives, and friends for up to six days per calendar quarter. A therapeutic leave visit may not exceed three days. Visits may not be combined to exceed the three day limit.
- (2) Payments to ICF/IID facilities for therapeutic visits are limited to 14 days per calendar month.
- (3) The nursing facility must ensure that each therapeutically indicated visit by a patient to home, relatives, or friends is authorized and certified by a physician.
- (4) Medicaid shall not be responsible for the record keeping process involving therapeutic leave.
- (5) A nursing facility must provide written notice to the resident and a family member or legal representative of the above specifying the Medicaid policy upon a resident taking therapeutic leave and at the time of transfer of a resident to a hospital.
Author: Robin Arrington, Associate Director, LTC Provider Recipient/Services Unit
Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. §§401, et seq.; 483.12.
History: New Rule: Filed August 11, 2003; effective September 11, 2003. Amended: Filed November 8, 2006; effective December 13, 2006. Amended: Filed January 11, 2017; effective February 25, 2017.