H-1937.1 _______________________________________________
SUBSTITUTE HOUSE BILL 1226
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State of Washington 52nd Legislature 1991 Regular Session
By House Committee on Health Care (originally sponsored by Representatives Prentice, Wood, Franklin, Braddock, May, Brekke, Leonard, Belcher, Day, Brough, R. Meyers, Morris, Pruitt, Silver, D. Sommers, Dellwo, Jones, Riley, Scott, Sheldon, Phillips, Orr, Basich, Ogden and Cantwell).
Read first time February 25, 1991.
AN ACT Relating to nursing homes; amending RCW 74.46.620; adding a new section to chapter 74.42 RCW; and adding a new section to chapter 74.46 RCW.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1. A new section is added to chapter 74.42 RCW to read as follows:
Each time a medicaid recipient is discharged from a medicaid provider's facility for the purpose of hospitalization, the provider shall hold open the recipient's bed for the recipient for a minimum of five days immediately following the day of discharge and shall not deny the recipient readmission and placement in the same bed vacated if sought during such five-day period following the day of discharge. If the medicaid recipient is eligible for medicare, the recipient may be readmitted to a bed in a medicare distinct part. In addition, the medicaid recipient may be readmitted to bed in a heavy care wing of the medicaid provider's facility, if the attending physician determines that the recipient's health status warrants the additional heavy care.
Sec. 2. RCW 74.46.620 and 1980 c 177 s 62 are each amended to read as follows:
(1) The department will reimburse a contractor for service rendered under the facility contract and billed in accordance with RCW 74.46.610.
(2) The amount paid will be computed using the appropriate rates assigned to the contractor, subject to the provisions of subsection (4) of this section.
(3) For each recipient, the department will pay an amount equal to the appropriate rates, multiplied by the number of patient days each rate was in effect, less the amount the recipient is required to pay for his or her care as set forth by RCW 74.46.630.
(4) If a recipient is discharged from the contractor's facility for the purpose of temporary hospitalization, the department shall reimburse at the facility-assigned rate, minus the amount the recipient is required to pay, for each day the recipient's bed is held vacant, for a maximum of three days, including the day of discharge. The department shall reimburse at fifty percent of the facility-assigned rate, minus the amount the recipient is required to pay, for each day the bed is held vacant for a resident's hospitalization, for an additional maximum of three days beyond the three days a vacant bed is reimbursed at the full rate for the same purpose. The four and one-half days a contractor's facility is reimbursed in full, for the purpose of temporary hospitalization, shall be considered part of the eighteen days maximum per year a resident can vacate the bed for social leave time. There shall be no reimbursement for a bed held vacant for a recipient unless:
(a) The recipient's facility had a minimum average occupancy rate of at least ninety-five percent, including hospitalized residents for whom beds were held vacant, during the calendar month immediately preceding the month of discharge; and
(b) The recipient is in fact readmitted to the facility to the same bed directly.
NEW SECTION. Sec. 3. A new section is added to chapter 74.46 RCW to read as follows:
The department shall develop and adopt rules to accurately keep record of a resident's social leave time and hospitalization time in compliance with RCW 74.46.620.