| TO: | ALL COUNTY OFFICES |
| FROM: | JANEL R. LUCK, DIRECTOR |
| SUBJECT: | CHANGE IN LEVELS OF LICENSURE FOR NURSING FACILITIES |
FORMS MANUAL REVISION #DISCUSSION:
Senate Bill 616 (2006) modified Sections 198.005, 198.006, and 198.073 RSMo changing levels of licensure of some of the types of nursing facilities licensed by the Department of Health and Senior Services (DHSS) based upon a change in the criteria DHSS uses to license facilities. The type of licensed facility determines the maximum grant payable to an individual receiving assistance through the Supplemental Nursing Care (SNC) Program. The Supplemental Nursing Care Manual is updated. The changes are:
- A Residential Care Facility I (RCF I) is renamed Residential Care Facility (RCF).
- DHSS will no longer license a new facility as a Residential Care Facility II (RCF II). However, any facility licensed as an RCF II on August 27, 2006, remains licensed if they continue to comply with the former RCF II licensure requirements. No facility licensed after August 28, 2006, can be licensed as an RCF II facility.
- Assisted Living Facility (ALF) is a level of care used for licensure. An Assisted Living Facility is designated by DHSS as Option 1 or Option 2, depending on the level of care needed by the residents.
The Supplemental Nursing Care grant amounts remain unchanged. The SNC payment for an Assisted Living Facility is the same as the amount of grant payable to an RCF II. RCF grants are payable at the same rate as the amount payable to the former RCF I facility.
Use the chart below to determine the correct SNC grant amount:
| Residential Care Facility (formerly RCF I) | $156.00 |
| Residential Care Facility II (continues to comply with former RCF II requirements) | $292.00 |
| Assisted Living Facility, Option 1 or 2 | $292.00 |
| Intermediate or Skilled (Participant's Medical Necessity for SNC is substantiated by Level of Care Determination) | $390.00 |
| Intermediate or Skilled (Participant's Medical Necessity for SNC is not substantiated by Level of Care Determination) | $292.00 |
IMU5 Coding
If a facility is licensed as a Residential Care Facility (former RCF I), use code B in Field 13G of IMU5 or code P for DMH placement. If the facility is licensed as an Assisted Living Facility or Residential Care Facility II (RCF II), use the IMU5 codes formerly corresponding to RCF II facilities. These codes are Y in Field 13G of IMU5 or X for DMH placement. The IMU5 code sheet is updated to reflect these changes.
Verification of Licensure Type
Access the DHSS Intranet link: www.dhss.mo.gov/showmelongtermcare/ “Locate a Long Term Care Facility” to verify the level of licensure for specific facilities. These are being updated by DHSS as the license changes.
NECESSARY ACTION:
- Review this memorandum with all appropriate staff.
- Begin using these new guidelines immediately.