KRS § 205.558 — KY Code / Title XVII / Chapter 205 / Section 205.558
205.558 Prescreening and admissions review system
Status: in_force

205.558 Prescreening and admissions review system.

(1) To prevent inappropriate placement and to contain costs related thereto, the

secretary for health and family services shall implement a statewide prescreening

and admissions review system, including the imposition of a resource means test,

for all long-term-care facilities and beds, as defined under KRS Chapter 216, and

any acute-care hospital-based skilled-nursing or intermediate-care beds participating

under Title XIX of the Social Security Act, regardless of the payment status of the

resident upon admission. Any person having resources sufficient to cover the cost of

care for at least three hundred sixty-five (365) days following admission may be

admitted to a long-term care bed or facility if such person so desires; provided,

however, that if a person:

(a) Is admitted to a long-term-care facility or acute-care hospital-based skilled-

nursing or intermediate-care bed without participating in the prescreening and

admissions review system; or

(b) Participates in the prescreening and admissions review system and is not

authorized for placement in a long-term-care facility or acute-care hospital-

based skilled-nursing or intermediate-care bed;

such person is not eligible for medical assistance payment for skilled-nursing or

intermediate-care for one (1) year after the date of the person's admission to a

skilled-nursing or intermediate-care facility or acute-care hospital-based skilled-

nursing or intermediate-care bed unless the person subsequently participates in the

prescreening and admissions review system and is authorized for admission to an

intermediate-care or skilled-nursing facility or acute-care hospital-based skilled-

nursing or intermediate-care bed.

(2) To implement the provisions of this section the cabinet shall establish preadmission

screening teams composed of a nurse, social worker, and physician.

(3) Before preauthorization of any person for admission to an intermediate-care facility

or skilled-care facility or acute-care hospital-based skilled-nursing or intermediate-

care bed, the cabinet shall first make the following determinations:

(a) The health status and care needs of the person require immediate

institutionalization in an intermediate-care facility or skilled-nursing facility

or acute-care hospital-based skilled-nursing or intermediate-care bed;

(b) The person and his family have been fully advised of alternatives to

institutional care and possible sources of reimbursement for such care;

(c) Alternatives to institutional care are not feasible; and

(d) Other such determinations as specified by administrative regulations

promulgated by the cabinet under KRS Chapter 13A.

(4) Admission of a person to an intermediate-care facility, or a skilled-nursing facility

without first obtaining prior authorization from the Cabinet for Health and Family

Services shall constitute a Class B violation.

(5) The secretary for the cabinet shall promulgate such administrative regulations,

subject to KRS Chapter 13A, as necessary to implement this section.