Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 332 - MAINECARE ELIGIBILITY MANUAL › Appendix 144-332-G - Supplies Provided to Recipients in a Nursing Facility

Current through 2024-29, July 17, 2024
Below is a list of Supplies and Equipment provided to
				  recipients by a Nursing Facility as part of regular rate of
				  reimbursement:
The following items may not be billed by either the facility
				  or supplier. Facilities which service a special group of the disabled are
				  expected to furnish that equipment which is normally used in their care (e.g.
				  children's wheelchairs) as a part of their reasonable cost.
Routine supplies and personal care items which are provided
				  by the Nursing Facility under 67.05-11(A), may not be purchased by a resident
				  and then deducted from their cost of care. The Nursing Facility must provide
				  any brand name item to the resident as part of the Nursing Facility regular
				  rate of reimbursement if the resident has a therapeutic need as documented by
				  the physician.
1. Alcohol, swabs and rubbing
2. Analgesics: (non-prescription):
1) Acetaminophen: tablets, 325 mg, 500 mg; liquid;
				  suppositories, 325 mg, 650 mg.
2) Aspirin: tablets, 325 mg, plain, buffered, coated;
				  suppositories, 325 mg, 650 mg.
3. Antacids: aluminum hydroxide, magnesium hydroxide: gel and
				  tablets (ex. Maalox).2) Aluminum/magnesium hydroxide with simeth icone (ex.
				  Mylanta, Maalox Plus).3) Calcium carbonate tablets (ex. Tums).4) Calcium
				  carbonate/magnesium hydroxide tablets (ex. Rolaids).
4. Alternating pressure pads, air mattresses, "Egg crate"
				  mattresses, gel mattresses
5. Applicators
6. Bandages
7. Band-Aids
8. Basins
9. Beds (standard hospital type, not therapy beds)
10. Bed pans
11. Bed rails
12. Blood pressure equipment
13. Bottles (water)
14. Canes
15. Calcium supplements:
1) Calcium carbonate (ex. Tums).
2) Calcium carbonate with vitamin D (ex. Oscal).
16. Catheters 17. Catheter trays (disposable)
18. Chairs (standard, geriatric)
19. Combs
20. Commodes
21. Corner chair
22. Cotton
23. Cough syrup & expectorants:(non prescription)
1) Guaifenesin (ex. Robitussin).
2) Guaifenesin - DM (ex. Robitussin DM)
3) Ammonium chloride/diphenhydramine (ex. Benylin).
24. Crutches 25. Cushions (e.g., comfort rings)
26. Dietary supplements
27. Disinfectants
28. Douche trays (disposable)
29. Dressings
30. Enema equipment
31. Enteral feedings, supplies and equipment
32. Facility deodorants
33. Gauze bandages (sterile & unsterile)
34. Glucometers
35. General services such as administration of oxygen and
				  related medications, hand feeding, incontinency care, tray service and
				  enemas
36. Gloves (sterile)
37. Gloves (unsterile)
38. Gowns
39. Hemorrhoidal preparations
40. Ice bags
41. Incontinent supplies full brief - all sizes; bed pans;
				  undergarment liners, disposable or reusable; under pads.
42. Iron supplements (oral: ferrous sulfate; ferrous
				  gluconate; liquid and/or tablet
43. Irrigation trays
44. Laundry services, personal (including supplies and
				  equipment)
45. Laxatives: Stool softeners: docusate sodium liquid or
				  capsule. Bulk: psyllium. Stimulants: Bisacodyl tablets and suppositories;
				  docusateca santhranol, liquid and/or capsule. Enemas: saline; phosphate types
				  (ex. Fleets); oil retention. Misc.: Milk of Magnesia; glycerin suppositories;
				  lactulose and analogs (when used as a laxative); mineral oil.
46. Lotions (emollient) and Lubricants (skin, bath
				  oil)
47. Mouth wash
48. Ointments and creams ( over the counter), including
				  petroleum jelly and hydrocortisone 0.5%
49. Ophthalmic lubricants: tears, ointments
50. Oxygen, for emergency and prn use only
51. Parenteral solutions, supplies and equipment
52. Pillows
53. Pitchers (water)
54. Powders (medicated and baby)
55. Prone boards
56. Rectal medicated wipes
57. Restraints (posey, thoracic chest supports, tilt in
				  space chairs, wedge pillows, etc.)
58. Shampoo: three types:
1) regular;
2) medicated; and
3) no tears - baby shampoo
59. Sheepskin
60. Shower chairs/ Tub seats
61. Soap: include one hypoallergenic type
62. Special dietary supplements
63. Specimen containers
64. Sterile I.V. or irrigation solution
65. Stethoscope
66. Sunscreen - level 30
67. Supplies (non-prescription) necessary for the treatment
				  of decubiti
68. Suture sets
69. Swabs, medicated or unmedicated
70. Syringes and needles
71. Tapes
72. Testing materials to be used by staff or facility
73. Thermometers
74. Tissues
75. Toothbrush
76. Toothpaste - two types accepted by AFA; and a denture
				  cleaner
77. Towels, washcloths
78. Tongue depressors
79. Traction equipment
80. Trapezes
81. Tubes (gavage, lavage, etc.)
82. Urinals
83. Urinary drainage equipment and supplies
				  (disposable)
84. Vitamins: two brands acceptable to pharmacy and dietary
85. Walkers
86. Wheelchairs - standard, including those with removable
				  arms and leg rests, pediatric, "hemi" chairs, reclining wheelchairs
87. Routine personal hygiene and grooming to include, but not
				  limited to: shave, shampoo, bathing, nail clipping (unless specified as a
				  covered service by a podiatrist in the MaineCare Benefits Manual), unless the
				  services of a barber or hairdresser are requested by and paid for by the
				  resident
88. Routine transportation of residents or laboratory
				  specimens to hospital or doctors offices