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Rule 5160-3-43.1 | Nursing facilities (NFs): case mix assessment instrument - minimum data set version 3.0 (MDS 3.0).

...ents. (3) NFs must use the MDS 3.0 discharge item set for any residents who transfer or are discharged, and the MDS 3.0 tracking record for any residents entering or reentering or who died in the facility in accordance with 42 C.F.R. 483.20. (4) NFs must use the MDS correction request in section X of the MDS 3.0 for modification or inactivation of MDS records that have been accepted into the CMS...

Rule 5160-3-43.3 | Nursing facilities (NFs): calculation of case mix scores.

...tifying the failed edits. (4) The "Discharge and Reentry Tracking Form Summary," which identifies all discharge assessments and reentry tracking forms that were received by ODM. (H) ODM shall provide two preliminary "Calculation of Facility Case Mix Scores" reports. The first report will reflect records submitted up to the quarterly filing date. The second report will reflect records submitt...

Rule 5160-4-06 | Specific provisions for evaluation and management (E&M) services.

...n services (including admission and discharge services). Payment may be made for not more than twenty-two hours of medical observation of an individual who is treated in a hospital but does not require inpatient hospital admission. (a) Emergency department services are not observation. (b) If during observation the individual is admitted to the hospital as an inpatient, payment for the obser...

Rule 5160-4-06 | Specific provisions for evaluation and management (E&M) services.

...n services (including admission and discharge services). Payment may be made for not more than twenty-two hours of medical observation of an individual who is treated in a hospital but does not need to be admitted as an inpatient. (a) Emergency department services are not observation. (b) If during observation the individual is admitted to the hospital as an inpatient, payment for the observ...

Rule 5160-4-06 | Specific provisions for evaluation and management (E&M) services.

...n services (including admission and discharge services). Payment may be made for not more than twenty-two hours of medical observation of an individual who is treated in a hospital but does not need to be admitted as an inpatient. (a) Emergency department services are not observation. (b) If during observation the individual is admitted to the hospital as an inpatient, payment for the observ...

Rule 5160-7-01 | Podiatry services.

... Home services; and (b) Hospital discharge services, thirty minutes or less. (3) Payment for the debridement of nails is limited to one treatment per sixty-day period. (4) Payment may be made for the following services only if an individual has a localized infection; is under the care of another healthcare practitioner for a metabolic disease such as diabetes mellitus or another condi...

Rule 5160-10-09 | DMEPOS: apnea monitors.

...; (vi) An abnormal pneumogram at discharge from a medical facility; (vii) Severe gastroesophageal reflux and associated apnea; (viii) Severe upper airway abnormality (e.g., achondroplasia, Pierre Robin syndrome); or (ix) Another, specified disorder necessitating close cardiorespiratory monitoring to facilitate a more timely discharge to home from a medical facility; and (b) An...

Rule 5160-10-09 | DMEPOS: apnea monitors.

...endence; (f) An abnormal pneumogram at discharge from a medical facility; (g) Severe gastroesophageal reflux and associated apnea; (h) Severe upper airway abnormality (e.g., achondroplasia, Pierre Robin syndrome); or (i) Another, specified disorder necessitating close cardiorespiratory monitoring to facilitate a more timely discharge to home from a medical facility; and (ii) An atte...

Rule 5160-10-13 | DMEPOS: oxygen.

...care facility (LTCF) who is being discharged or will be discharged, then the evaluation period is thirty days, and the most recent blood gas study performed within forty-eight hours before discharge is used. (ii) Otherwise, the evaluation period is thirty days, and the most recent blood gas study performed within thirty days before the date of certification is used. (4) A renewing CMN ...

Rule 5160-10-13 | DMEPOS: oxygen.

...rformed within forty-eight hours before discharge is used. (ii) Otherwise, the most recent blood gas study performed within the preceding twelve months may be used. (4) A renewing CMN is used to extend certification. (a) If the need for oxygen was established through a respiratory study in which a positive airway pressure device was shown to be effective only when supplemental oxygen ...

Rule 5160-12-01 | Home health services: provision requirements, coverage and service specification.

...sixty consecutive days from the date of discharge from an inpatient hospital stay if all of the following are met as certified by the qualifying treating clinician using the ODM 07137: (1) The individual is discharged from a covered inpatient hospital stay of three or more days, with the discharge date recorded on form ODM 07137. It is considered one inpatient hospital stay when an individual is...

Rule 5160-12-02 | Private duty nursing services: provision requirements, coverage and service specification.

...y consecutive days from the date of discharge from an inpatient hospital stay of three or more covered days in accordance with rule 5160-2-03 of the Administrative Code. For purposes of this rule, a covered inpatient hospital stay is considered one hospital stay when an individual is transferred from one hospital to another hospital, either within the same building or to another location. (a) The...

Rule 5160-12-08 | Registered nurse assessment and registered nurse consultation services.

...nd any resulting activities; and (w) A discharge summary signed and dated by the directing RN, at the point the RN is no longer going to provide assessment and consultation services to the individual or when the individual no longer needs services from the supervising RN. The summary should include information regarding the progress made toward goal achievement and indicate any recommended follow-ups...

Rule 5160-12-08 | Registered nurse assessment and registered nurse consultation services.

...nd any resulting activities; and (w) A discharge summary signed and dated by the directing RN, at the point the RN is no longer going to provide assessment and consultation services to the individual or when the individual no longer needs services from the supervising RN. The summary should include information regarding the progress made toward goal achievement and indicate any recommended follow-ups...

Rule 5160-18-02 | Pediatric recovery centers (PRCs).

...ned by hospital or other facility discharge; and (iii) The infant's parent or caregiver would benefit from additional education and support services regarding care for the patient. (c) The PRC develops and implements a program for parents and caregivers of the infant, either individually or in a group setting to address: (i) Activities to encourage caregiver-infant bonding. (ii) Ad...

Rule 5160-19-01 | Comprehensive primary care (CPC) program: eligible providers.

...plete the "follow-up after hospital discharge" activities in which the CPC entity will have established relationships with all emergency departments and hospitals from which it frequently receives referrals and has an established process to ensure a reliable flow of information. (7) Complete the "tests and specialist referrals" activities in which the CPC entity will have established bi-direc...

Rule 5160-19-01 | Comprehensive primary care (CPC) program: eligible providers.

...plete the "follow-up after hospital discharge" activities in which the CPC entity will have established relationships with all emergency departments and hospitals from which it frequently receives referrals and has an established process to ensure a reliable flow of information. (7) Complete the "tests and specialist referrals" activities in which the CPC entity will have established bi-direc...

Rule 5160-19-01 | Comprehensive primary care (CPC) program: eligible providers.

... Complete the "follow-up after hospital discharge" activities in which the CPC entity will have established relationships with all emergency departments and hospitals from which it frequently receives referrals and has an established process to ensure a reliable flow of information. (7) Complete the "tests and specialist referrals" activities in which the CPC entity will have established bi-directional communication...

Rule 5160-19-03 | Comprehensive maternal care program.

... ODM. (7) Follow-up after hospital discharge. It is the responsibility of the CMC entity to: (a) Establish relationships with emergency departments (EDs) and hospitals from which it frequently sends and receives referrals and has an established process to ensure a reliable flow of information; (b) Proactively and consistently obtain patient discharge summaries from hospitals and other facilitie...

Rule 5160-19-03 | Comprehensive maternal care program.

... ODM. (7) Follow-up after hospital discharge. It is the responsibility of the CMC entity to: (a) Establish relationships with emergency departments (EDs) and hospitals from which it frequently sends and receives referrals and has an established process to ensure a reliable flow of information; (b) Proactively and consistently obtain patient discharge summaries from hospitals and other facilities, a...

Rule 5160-19-03 | Comprehensive maternal care program.

...ment box. (7) Follow-up after hospital discharge. It is the responsibility of the CMC entity to: (a) Establish relationships with emergency departments (EDs) and hospitals from which it frequently sends and receives referrals and has an established process to ensure a reliable flow of information; (b) Proactively and consistently obtain patient discharge summaries from hospitals and other facilities, and connect i...

Rule 5160-20-01 | Coordinated services program.

...ndividual's assigned pharmacy following discharge from an inpatient treatment program for addiction, upon request.

Rule 5160-21-04 | Reproductive health services: pregnancy-related services.

...Code. Postpartum care rendered prior to discharge from the facility is considered incidental to the delivery. (d) Family planning services. Policies governing payment for these services are set forth in rules 5160-21-02 and 5160-21-02.2 of the Administrative Code. (3) Payment may be made for one report of a pregnancy that is diagnosed in conjunction with an E&M service not associated with a norm...

Rule 5160-21-04 | Reproductive health services: pregnancy-related services.

...Code. Postpartum care rendered prior to discharge from the facility is considered incidental to the delivery. (d) Family planning services. Policies governing payment for these services are set forth in rules 5160-21-02 and 5160-21-02.2 of the Administrative Code. (3) Payment may be made for one report of a pregnancy that is diagnosed in conjunction with an E&M service not associated with a norm...

Rule 5160-21-04 | Reproductive health services: pregnancy-related services.

...Code. Postpartum care rendered prior to discharge from the facility is considered incidental to the delivery. (d) Family planning services. Policies governing payment for these services are set forth in rules 5160-21-02 and 5160-21-02.2 of the Administrative Code. (3) Payment may be made for one report of a pregnancy that is diagnosed in conjunction with an E&M service not associated with a norm...