20 CAR pt. 579, Appendix D
Long Term Care Facilities are required to maintain a daily midnight census of residents in their facility. Resident day information must be accumulated in a clear, accurate and auditable format. Resident day information is an important component of the cost reporting process. The daily midnight census documents resident day information stated on the facility's cost report. This information must be retained by the facility for no less than five years following the date cost reports are submitted to the Division of Medical Services. Facilities that do not maintain accurate and auditable census information are in violation of their provider agreement and may be subject to civil penalty.
The codes and form located in Section V of the Arkansas Medicaid Provider Manuals, provide an easily understood method for accumulating daily census information. The provider may utilize the codes and form or may construct their own form which contains all elements of the referenced form. The codes and form can be found by clicking the hyperlink, 'Section V'.
An actual physical census of a facility's residents should be conducted each midnight and recorded on the daily census form. This ensures that the day of admission is included as a resident day while the day of discharge is not.
Facilities that certify that occupancy levels are eighty-five percent (85%) or greater will be paid up to five (5) consecutive days for a leave of absence (LOA) to the hospital. The date on which the provider must meet occupancy requirements depends on their billing method. Providers billing on a TAD must certify eighty-five percent (85%) occupancy on the last day of the month the LOA occurred. Providers billing on an electronic billing system must certify eighty-five percent (85%) occupancy for the last day of the month previous to the LOA.
Facilities may bill for up to fourteen consecutive days for therapeutic home visits regardless of the occupancy rate.
LOA days paid for both hospital and therapeutic home visits must be properly identified on the daily census. These days are included in resident day totals for cost reporting purposes.