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205.558 Prescreening and admissions review system.

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205.558 Prescreening and admissions review system. (1) To prevent inappropriate placement and to contain costs related thereto, the secretary for health and family services shall implement a statewide prescreening <br>and admissions review system, including the imposition of a resource means test, <br>for all long-term-care facilities and beds, as defined under KRS Chapter 216, and <br>any acute-care hospital-based skilled-nursing or intermediate-care beds participating <br>under Title XIX of the Social Security Act, regardless of the payment status of the <br>resident upon admission. Any person having resources sufficient to cover the cost of <br>care for at least three hundred sixty-five (365) days following admission may be <br>admitted to a long-term care bed or facility if such person so desires; provided, <br>however, that if a person: <br>(a) Is admitted to a long-term-care facility or acute-care hospital-based skilled-nursing or intermediate-care bed without participating in the prescreening and <br>admissions review system; or (b) Participates in the prescreening and admissions review system and is not authorized for placement in a long-term-care facility or acute-care hospital-<br>based skilled-nursing or intermediate-care bed; such person is not eligible for medical assistance payment for skilled-nursing or <br>intermediate-care for one (1) year after the date of the person's admission to a <br>skilled-nursing or intermediate-care facility or acute-care hospital-based skilled-<br>nursing or intermediate-care bed unless the person subsequently participates in the <br>prescreening and admissions review system and is authorized for admission to an <br>intermediate-care or skilled-nursing facility or acute-care hospital-based skilled-<br>nursing or intermediate-care bed. (2) To implement the provisions of this section the cabinet shall establish preadmission screening teams composed of a nurse, social worker, and physician. (3) Before preauthorization of any person for admission to an intermediate-care facility or skilled-care facility or acute-care hospital-based skilled-nursing or intermediate-<br>care bed, the cabinet shall first make the following determinations: <br>(a) The health status and care needs of the person require immediate institutionalization in an intermediate-care facility or skilled-nursing facility <br>or acute-care hospital-based skilled-nursing or intermediate-care bed; (b) The person and his family have been fully advised of alternatives to institutional care and possible sources of reimbursement for such care; (c) Alternatives to institutional care are not feasible; and <br>(d) Other such determinations as specified by administrative regulations promulgated by the cabinet under KRS Chapter 13A. (4) Admission of a person to an intermediate-care facility, or a skilled-nursing facility without first obtaining prior authorization from the Cabinet for Health and Family <br>Services shall constitute a Class B violation. (5) The secretary for the cabinet shall promulgate such administrative regulations, subject to KRS Chapter 13A, as necessary to implement this section. Effective: June 20, 2005 <br>History: Amended 2005 Ky. Acts ch. 99, sec. 232, effective June 20, 2005. -- Amended 1998 Ky. Acts ch. 426, sec. 198, effective July 15, 1998. -- Created 1986 Ky. Acts <br>ch. 466, sec. 3, effective July 15, 1986.