From September 16, 2019, your arbitration practices and agreements must comply with the requirements of the CMS Final Arbitration Rule of 2019. Agreements reached before September 16, 2019 remain valid. 8 STATE OF CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY YOU SHOULD BE AWARE THAT NO FACILITY THAT PARTICIPATES IN THE MEDI-CAL PROGRAM MAY REQUIRE ANY RESIDENT TO REMAIN IN PRIVATE PAY STATUS FOR ANY PERIOD OF TIME BEFORE CONVERTING TO MEDI-CAL COVERAGE. NOR, AS A CONDITION OF ADMISSION OR CONTINUED STAY IN SUCH A FACILITY, MAY THE FACILITY REQUIRE ORAL OR WRITTEN ASSURANCE FROM A RESIDENT THAT HE OR SHE IS NOT ELIGIBLE FOR, OR WILL NOT APPLY FOR, MEDICARE OR MEDI-CAL BENEFITS. A. Fees for Private Paying Residents Our establishment calculates the following basic prices: for a single room for one room with two beds for one room with three beds for (Include all other accommodations here) The daily basic price for private payment and insured private residents includes payment for the services and supplies described in Schedule B-1. The principle of the day is calculated for the day of admission, but not for a day that goes beyond the date of dismissal or death. However, if you are voluntarily released from the facility less than 3 days after the date of admission, we may charge you a maximum of 3 days at the basic daily rate. We will provide you with a written message 30 days before the day`s principle increases, unless the increase is necessary because the state raises the Medi-Cal rate to a level above our normal rate.
In this case, state law waives the 30-day notification. Appendix B-2 list for private payment and optional private insured residents of deliveries and services are not included in our basic daily rate, and our fees for these deliveries and services. We only charge for optional supplies and services that you specifically request, unless delivery or service is required in the event of an emergency. We will provide you with a written message of 30 days before any increase in fees for optional supplies and services. If you are eligible for Medi-Cal after your entry, the services and deliveries included in the daily price as well as the list of optional deliveries and services may change. When Medi-Cal confirms that it will pay for your stay at this property, we will check and explain any changes in coverage. CDPH 327 (05/11) – 5 – Advance policy is the general term used to describe the instructions you give someone about preferences for your future medical treatment. Upon admission, the nursing home must provide you with written information on advance directives explaining: (1) your right to guide your own health care decisions; (2) Your right to accept or refuse medical treatment; (3) your right, under California law, to prepare a prior health care directive; and (4) the ease policy that governs the application of advance directives. (Title 42 U.S. Code No.
1395cc (f), 1396r (c) (2) (E) – 1396a (w), Title 42 Federal Code Code nr. 489.102, 483.10 (b)(8) – 431.20) In recent years, some care homes have informed residents and their representatives of the need for a POLST form upon admission. It`s not true. Setting up a POLST is a choice, not a prerequisite.