Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Services


CBRFs serve people who do not require care above an intermediate level of nursing care and need no more than 3 hours of nursing services per week. Nursing care includes anything that is covered by the state's nurse practice act, including tasks that can be delegated, e.g., dressing changes. Assistance with ADLs is not considered a nursing task. Nurses do not have to be on site to supervise delegated tasks. Nurses can be paid hourly or on retainer for a certain number of hours per week. Exceptions to the hourly limits are made for temporary conditions lasting no more than 90 days or longer with department approval.

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