New York Codes, Rules and Regulations › Title 14 - DEPARTMENT OF MENTAL HYGIENE › Chapter XIII - Office of Mental Health › Part 576 - Standards Pertaining To Payment For Residential Treatment Facilities For Children And Youth › Section 576.6 - Standards pertaining to reserved bed days

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The purpose of reserving a bed and making
				payment for the days for which a bed is reserved is to make provision for the
				continued availability of services in the same residential treatment facility
				for residents who are temporarily hospitalized or who are on leave of absence
				for a therapy day. A bed may be reserved only for a resident who has been
				residing in the residential treatment facility for at least 15 consecutive days
				since the resident's current initial admission to the residential treatment
				facility.
(1) A bed may be reserved for a
				resident who is temporarily hospitalized for medical or psychiatric care if the
				following conditions are met:
(i) The resident
				is admitted to a hospital, other than a residential treatment facility, which
				is currently licensed or otherwise authorized to operate pursuant to the laws
				of the jurisdiction in which the hospital is located.
(ii) The resident is expected, on the day of
				admission to the hospital, to return to the residential treatment facility in
				no more than 15 calendar days.
(iii) The residential treatment facility
				notifies the hospital by telephone, and confirms in writing in accordance with
				procedures prescribed by the Office of Mental Health, that the resident's bed
				is being reserved and that the hospital must notify the residential treatment
				facility during the period that the bed is being reserved of any change in the
				resident's condition which affects the date of discharge.
(a) On or before the morning of the fourth
				day of hospital care, the hospital shall notify the residential treatment
				facility of the resident's anticipated discharge date.
(b) If following the 3rd day and before the
				16th day of temporary hospitalization, it becomes necessary to adjust the
				planned discharge date as a result of either a change in the resident's
				condition or the availability of additional clinical information, the hospital
				shall immediately advise the residential treatment facility by
				telephone.
(iv) The bed
				reservation shall be extended under the following conditions:
(a) For a resident temporarily hospitalized
				for medical care the bed reservation shall be extended for up to five
				additional days, if granting such extension will permit the resident to return
				to the residential treatment facility within 20 days of the date of admission
				to the hospital.
(b) For a resident
				temporarily hospitalized for psychiatric care the bed reservation shall be
				extended for up to 15 additional days, if granting such extension will permit
				the resident to return to the residential treatment facility within 30 days of
				the date of admission to the hospital.
(v) Payment for reserved bed days for
				temporary hospitalization shall be requested as follows:
(a) When reserved bed days do not exceed 15
				days for any single hospital stay and the resident returns immediately to the
				residential treatment facility payment may be requested without prior
				authorization.
(b) When a bed
				reservation has been extended in accordance with clause (iv) (a) or (b) of this
				paragraph, and the resident returns immediately to the residential treatment
				facility, the residential treatment facility must request prior authorization
				from the Office of Mental Health to request payment for the actual period the
				bed was reserved.
(vi)
				The bed reservation shall be terminated under the following conditions:
(a) If the planned discharge date determined
				during the first 3 days of hospitalization is more than 15 days from the day of
				admission to the hospital, the bed reservation shall be terminated.
(b) If the planned discharge date determined
				following the third day of temporary hospitalization is more than 15 days from
				the day of admission to the hospital or, more than 20 days for medical care or
				more than 30 days for psychiatric care for bed reservations extended in
				accordance with clause (iv)(a) or (b) of this paragraph, the bed reservation
				shall be terminated.
(c) If the
				resident is discharged from the hospital and does not return to the residential
				treatment facility, the bed reservation shall be terminated on the day the
				resident is discharged from the hospital.
(vii) All of the above provisions in this
				paragraph are subject to a vacancy rate of no more than 5% or 2 vacant beds,
				whichever is greater, on the first day of resident's hospitalization from
				either the residential treatment facility or the distinct unit of the
				residential treatment facility, to which the resident is expected to return. A
				distinct unit will require specific admission criteria listed on the
				residential treatment facility's operating certificate but will not require a
				separate reimbursement rate for the unit. When computing a vacancy rate, the
				RTF must disregard beds that have been reserved for other patients.