"Adult Care Home" in Kansas means any nursing facility, nursing facility for mental health, intermediate care facility for the mentally retarded, assisted living facility, residential health care facility, homes plus, boarding care home, and adult day care facility. (KSA 39-923)
All adult care homes are required to be licensed by the Secretary of the Kansas Department on Aging (KDOA). KDOA's Licensure, Certification, and Evaluation Commission (LCE) is responsible for licensing, issuing operational rules and regulations, and certifying that providers meet regulatory requirements for Medicare / Medicaid participation.
The purpose of nursing facilities is to provide health care and related services to individuals requiring 24 hours per day, seven days per week care. Residents receiving services in a nursing facility require ongoing observation, treatment and care for either short or long-term stays due to illness, disease or injury.
Nursing facilities in the Medicaid program are required to provide the following services:
Some nursing facilities also elect to provide respite and adult day care.
Medicaid financial eligibility is determined by the Kansas Department of Social and Rehabilitation Services (SRS) field staff. The criteria for financial eligibility are listed on the SRS website at www.srskansas.org .
Medicaid functional eligibility is determined by KDOA staff based on the CARE assessment.
The nursing facility payment program is a division in the KDOA Program and Policy Commission. The division is responsible for enrolling providers and determining reimbursement rates for nursing facilities participating in the Medicaid program. KDOA reimburses approximately 346 Nursing facilities using a cost-based, facility specific, prospective payment system. The payment allowance for direct healthcare costs is adjusted quarterly based on the acuity of the Medicaid residents.
KDOA is responsible for monetary penalties, denial of payment for new Medicare and/or Medicaid admissions, and terminations of nursing facilities not in substantial compliance with federal participation requirements. Remedies imposed are from recommendations of the LCE surveyors based on the results of the survey process. Penalties for skilled nursing facilities not in compliance with Medicare participation requirements are imposed by the Centers for Medicare and Medicaid Services (CMS).
The CARE assessment meets the federal Pre-Admission Screening and Resident Review (PASRR) admission requirement for Medicaid-certified nursing facilities. It applies to all residents, regardless of payment source. The purpose of PASRR is to screen for mental illness, mental retardation, and related conditions to determine if nursing facility placement is appropriate.
For additional information on the Nursing Facility and CARE Programs, contact:
The Kansas Department on Aging, 503 Kansas Ave., Topeka, Kansas 66603-3404 or e-mail: wwwmail@aging.ks.gov or contact us by phone at 1-800-432-3535.