Legal Resources | | T22 51511.6
Payment for Services and Supplies. Nursing Facility Services - Pediatric Subacute Care Reimbursement
(a) The per diem rates of reimbursement for pediatric subacute services as defined in Section 51335.6(a) shall be as follows:
Licensure Type of Patient Rate of
Reimbursement
Effective Rate Year
2004-05 2005-06 2006-07
Hospital based Ventilator Dependent $719.71 $762.95 $785.01
Hospital based Non-ventilator Dependent $660.52 $700.10 $720.20
Freestanding Ventilator Dependent $673.08 $713.10 $733.52
Freestanding Non-ventilator Dependent $613.89 $650.25 $668.71
(b) The per diem rate of reimbursement for supplemental rehabilitation therapy services shall be as described below:
Effective Rate Year Per Diem Rate
2004-05 $43.13
2005-06 $46.05
2006-07 $47.46
This rate shall include payment for physical therapy, occupational therapy and speech therapy services provided in accordance with Section 51215.10(i) through (m).
(c) The per diem rate of reimbursement for ventilator weaning services shall be as described below:
Effective Rate Year Per Diem Rate
2004-05 $40.21
2005-06 $42.94
2006-07 $44.25
This rate shall include respiratory care practitioner and nursing care services provided in accordance with Section 51215.11.
(d) Payment to nursing facilities with pediatric subacute units for patients on bedhold receiving acute services shall be in accordance with Section 51535.1(d).
(e) The provisions of Section 51511 shall apply to pediatric subacute units except for Section 51511(a). Section 51511(c) shall apply to pediatric subacute units except as provided for in 51511.6(f).
(f) The pediatric subacute per diem rate includes the following:
(1) Equipment and supplies necessary for continuous intravenous therapy;
(2) Oxygen and all equipment necessary for administration including positive pressure apparatus;
(3) Ventilators, including calibration and maintenance;
(4) Registered Dietician consultant services;
(5) Respiratory therapy services;
(6) Physical, occupational and speech therapy services, as specified in Section 51215.10(h);
(7) Developmental services;
(8) Service Coordinator activities.
(9) Portable x-ray services when provided by freestanding providers.
Authority cited:
Health and Safety Code 20
Welfare and Institutions Code 10725
Welfare and Institutions Code 14105
Welfare and Institutions Code 14124.5
Reference:
Welfare and Institutions Code 14132.25
Statutes of 2004, Chapter 208 Items 4260-101-0001 and 4260-101-0890 Statutes of 2005, Chapter 38 Items 4260-101-0001 and 4260-101-0890 Statutes of 2006, Chapter 48 Items 4260-101-0001 and 4260-101-0890
(Amended by Register 2014, No. 21.)