Typically, this contract will not burden the facility with the obligation for items like power wheelchairs. Here again, the more practical course of action is to seek custom or non-standard equipment through regular Medicaid channels. The other practical consideration is that referrals often come in through the nursing facilities, with the expectation that the attorney or advocate will seek funding through the regular Medicaid channels. The per diem must take into account the cost of providing services that allow residents to attain or maintain the highest practicable physical, mental and psycho-social well being. Generally, states by regulation establish the per diem and what it pays for.
States usually describe the services paid for under the per diem in very general terms.
Some states specifically exclude custom equipment from the per diem . The following examples illustrate how some states handle reimbursement for custom equipment for nursing facility residents. Pennsylvania - The Medicaid program provides separate reimbursement outside of the facility per diem for durable medical equipment for nursing facility residents, if the equipment is significantly customized. Expensive noncustomized equipment, such as power wheelchairs, is not separately reimbursed outside of the per diem. Rickaby v. Wisconsin Dept. of Health and Soc.