Nursing Home Room and Board for Managed Care Participants
Except for certain hospice stays, the cost of staying in a nursing home is covered under Fee-For-Service (FFS) even if the participant is in a Managed Care health plan. Participants who are enrolled in a Managed Care health plan and need to move into a nursing home will stay in their Managed Care health plan until doctors decide they need nursing home level of care, or until 60 calendar days have passed, whichever comes first. The 60-day period begins after the DA-124 form is completed, so the Department of Health and Senior Services can review the participant's case and decide if they qualify for nursing home coverage.
For additional resources, refer to the Education and Training Resources page and/or sign up for a live webinar by accessing our Provider Training Calendar. Email MHD.Education@dss.mo.gov for more information.