950.1 Vendor payment for reserved bed days for hospitalization or therapeutic leaves of absence, for a resident of a nursing facility, when provided in the resident's plan of care, shall not exceed eighteen (18) days during any fiscal year, if there is a reasonable expectation that the resident will return to the nursing facility.

950.2 Vendor payment for reserved bed days for hospitalization, for a resident of an intermediate care facility for persons with mental retardation (ICFs/MR) shall not exceed fifteen (15) days during any fiscal year, if there is a reasonable expectation that the resident will return to the facility.

950.3 Vendor payment for reserved bed days for therapeutic leaves of absence, for a resident of an ICF/MR, when provided in the resident's plan of care shall not exceed forty-five (45) days during any fiscal year, if there is a reasonable expectation that the resident will return to the facility.

950.4 Payment for reserved bed days authorized in accordance with section 950.1 shall equal 100 percent of the facility's per diem rate.

950.5 Payment for reserved bed days authorized in accordance with sections 950.2 and 950.3 shall equal the facility's per diem rate and shall not include reimbursement for one to one services. A reserved bed day for purposes of this section is a day in which an ICF/MR resident receives fewer than eight of hours of supports in an ICF/MR beginning at midnight (12:00 am) and ending at 11:59 p.m.

950.6 Each resident shall reside in the nursing facility or ICF/MR for at least one day as a condition of vendor payment for reserved bed days.

950.7 Each provider shall require the family member or caregiver to sign a leave and request form upon exit and return to the facility. The provider shall ensure that each family member or caregiver provide contact information.

950.8 Each provider shall discuss the resident's medical regimen with the family member or caregiver. The provider shall ensure that each family member or caregiver is provided a sufficient quantity of the resident's medication for the leave period.

950.9 Each provider shall report to MAA any unusual incident that occurred during any therapeutic leave of absence.

AUTHORITY: The authority for §§950 - 960 is D.C. Code, 2001 Ed. §1-307.02; Reorganization Plan No. 4 of 1996, 3 D.C. Code, 2001 Ed. at 413; and Mayor's Order 97-42 (February 18, 1997).

SOURCE: Final Rulemaking published at 53 DCR 1370 (February 24, 2006); as Final Rulemaking published at 54 DCR 3879 (April 27, 2007).