DHS 107.09(4)(g)1.b.b. Provided by a facility located on an Indian reservation that furnishes, on a regular basis, health-related services and is licensed pursuant to s. 50.03, Stats., and ch. DHS 132. DHS 107.09(4)(g)2.2. Intermediate care services may include services provided in an institution for developmentally disabled persons if: DHS 107.09(4)(g)2.a.a. The primary purpose of the institution is to provide health or rehabilitation services for developmentally disabled persons; DHS 107.09(4)(g)3.3. Intermediate care services may include services provided in a distinct part of a facility other than an intermediate care facility if the distinct part: DHS 107.09(4)(g)3.b.b. Is an identifiable unit, such as an entire ward or contiguous ward, a wing, a floor, or a building; DHS 107.09(4)(g)3.d.d. Houses all recipients for whom payment is being made for intermediate care facility services, except as provided in subd. 4.; DHS 107.09(4)(g)4.4. If the department includes as intermediate care facility services those services provided by a distinct part of a facility other than an intermediate care facility, it may not require transfer of a recipient within or between facilities if, in the opinion of the attending physician, transfer might be harmful to the physical or mental health of the recipient. DHS 107.09(4)(h)(h) Determining the appropriateness of services at the skilled level of care. DHS 107.09(4)(h)1.1. In determining whether the services needed by a recipient can only be provided in a skilled nursing facility on an inpatient basis, consideration shall be given to the patient’s condition and to the availability and feasibility of using more economical alternative facilities and services. DHS 107.09(4)(h)2.2. If a needed service is not available in the area in which the individual resides and transporting the person to the closest facility furnishing the services would be an excessive physical hardship, the needed service may be provided in a skilled nursing facility. This would be true even though the patient’s condition might not be adversely affected if it would be more economical or more efficient to provide the covered services in the institutional setting. DHS 107.09(4)(h)3.3. In determining the availability of alternative facilities and services, the availability of funds to pay for the services furnished by these alternative facilities shall not be a factor. For instance, an individual in need of daily physical therapy might be able to receive the needed services from an independent physical therapy practitioner. DHS 107.09(4)(i)1.1. Each recipient who is a resident in a public or privately-owned nursing home shall have an account established for the maintenance of earned or unearned money payments received, including social security and SSI payments. The payee for the account shall be the recipient, a legal representative of the recipient or a person designated by the recipient as his or her representative. DHS 107.09(4)(i)2.2. If it is determined by the agency making the money payment that the recipient is not competent to handle the payments, and if no other legal representative can be appointed, the nursing home administrator may be designated as the representative payee. The need for the representative payee shall be reviewed when the annual review of the recipient’s eligibility status is made. DHS 107.09(4)(i)3.3. The recipient’s account shall include documentation of all deposits and withdrawals of funds, indicating the amount and date of deposit and the amount, date and purpose of each withdrawal. DHS 107.09(4)(i)4.4. Upon the death or permanent transfer of the resident from the facility, the balance of the resident’s trust account and a copy of the account records shall be forwarded to the recipient, the recipient’s personal representative or to the legal guardian of the recipient. No facility or any of its employees or representatives may benefit from the distribution of a deceased recipient’s personal funds unless they are specifically named in the recipient’s will or constitute an heir-at-law. DHS 107.09(4)(i)5.5. The department’s determination that a facility has violated this paragraph shall be cause for the facility to be decertified from MA. DHS 107.09(4)(j)1.1. Bedhold payments shall be made to a nursing home for an eligible recipient during the recipient’s temporary absence for hospital treatment, a therapeutic visit or to participate in a therapeutic rehabilitative program, if the following criteria are met: DHS 107.09(4)(j)1.a.a. The facility’s occupancy level meets the requirements for bedhold reimbursement under the nursing home reimbursement formula. The facility shall maintain adequate records regarding occupancy and provide these records to the department upon request; DHS 107.09(4)(j)1.b.b. For bedholds resulting from hospitalization of a recipient, reimbursement shall be available for a period not to exceed 15 days for each hospital stay. There is no limit on the number of stays per year. No recipient may be administratively discharged from the nursing home unless the recipient remains in the hospital longer than 15 days; DHS 107.09(4)(j)1.c.c. The first day that a recipient is considered absent from the home shall be the day the recipient leaves the home, regardless of the time of day. The day of return to the home does not count as a bedhold day, regardless of the time of day; DHS 107.09(4)(j)1.d.d. A staff member designated by the nursing home administrator, such as the director of nursing service or social service director, shall document the recipient’s absence in the recipient’s chart and shall approve in writing each leave;