MO HealthNet for the Aged, Blind, and Disabled

0815.005.10 MO HealthNet Certified Beds in Nursing Facilities

IM-#33, March 29, 2012

Nursing facilities (SNF) may designate some or all of their beds as MO HealthNet (MHN) certified beds (T19). This designation means that the facility must accept vendor payments for the individual assigned to that bed.

In a nursing facility with all MHN certified beds, vendor payments MUST be given to eligible participants. Supplemental Nursing Care (SNC) cash payments cannot be made to participants in a nursing facility where all beds are MHN certified.

In a nursing facility with only some MHN certified beds, SNC cash payments cannot be given to an individual in a MHN certified bed. Vendor benefits must be authorized if the individual is eligible and in a MHN certified bed, or at the time they are placed in a certified bed. However, if the eligible individual is not in a MHN certified bed and is not going to be transferred to one, approve for SNC even if there is an unoccupied MHN certified bed in the facility. See Section 0600.000.00 for information on SNC. Accept the statement of nursing home personnel regarding the individual’s placement in a MHN certified bed or a non-certified bed.

If the nursing facility places the individual in a Medicare certified bed (T18) and the facility states it will bill MO HealthNet for coinsurance and deductibles only, the individual should be treated as if s/he is in a MHN certified bed.