Effective May 1, 2017, managed care organizations (MCOs) will no longer be able to reimburse Nursing Facilities for Medicaid residents unless they have the proper Kansas Medical Assistance Program (KMAP) coding Level of Care (LOC) description – Nursing Facility.
To review the PASRR/CARE Level I Procedure for Nursing Facilities, reference the CARE Information page on the Kansas Department for Aging and Disability Services (KDADS) website.
- The procedure addresses:
- Less than 30 day admissions
- Emergency admissions
- Out of state admissions
- Terminal diagnosis admissions
If the appropriate procedure is not followed by the Nursing Facility, a lack of proper coding of the PASRR/CARE Level I will result in the delay or denial of reimbursement.
Nursing Facilities can verify that a beneficiary is coded properly through KMAP by ensuring the LOC description is coded as Nursing Facility in KMAP. Beneficiaries will be coded Nursing Facility after EITHER of the following have occurred:
- A Nursing Facility has followed the PASRR/CARE Level I Procedure (see above). The Aging and Disability Resource Center (ADRC) has entered the completed CARE Level I information.
- The hospital assessor has submitted CARE Level I information to KDADS for data entry. The Nursing Facility has notified the Kansas Department of Health and Environment (KDHE) via Form 2126 of admission into the Nursing Facility. KDHE has requested/received CARE information from KDADS.
If providers have questions regarding the status of a LOC description within KMAP, they may contact KMAP Customer Service at 1-800-933-6593. If there are questions specific to the CARE Level I process, they may contact Ellen Bartz at (785) 368-7323 or email KDADS.CARE@KS.GOV.
Further information regarding access to resident information on KMAP is available on the KMAP website. Further information and training on the CARE/PASRR process are available on the CARE Information page of the KDADS website.
