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; DHS 107.09(4)(j)1.e.e. Claims for bedhold days may not be submitted when it is known in advance that a recipient will not return to the facility following the leave. In the case where the recipient dies while hospitalized, or where the facility is notified that the recipient is terminally ill, or that due to changes in the recipient’s condition the recipient will not be returning to the facility, payment may be claimed only for those days prior to the recipient’s death or prior to the notification of the recipient’s terminal condition or need for discharge to another facility; DHS 107.09(4)(j)1.f.f. For bedhold days for therapeutic visits or for participation in therapeutic/rehabilitative programs, the recipient’s physician shall record approval of the leave in the physician’s plan of care. This statement shall include the rationale for and anticipated goals of the leave as well as any limitations regarding the frequency or duration of the leave; and DHS 107.09(4)(j)1.g.g. For bedhold days due to participation in therapeutic/rehabilitative programs, the program shall meet the definition of therapeutic/rehabilitative program under s. DHS 101.03 (175). Upon request of the department, the nursing home shall submit, in writing, information on the dates of the program’s operation, the number of participants, the sponsorship of the program, the anticipated goals of the program and how these goals will be accomplished, and the leaders or faculty of the program and their credentials. DHS 107.09(4)(j)2.2. Bedhold days for therapeutic visits and therapeutic/rehabilitative programs and hospital bedhold days which are not separately reimbursed to the facility by MA in accordance with s. 49.45 (6m), Stats., may not be billed to the recipient or the recipient’s family. DHS 107.09(4)(k)(k) Private rooms. Private rooms shall not be a covered service within the daily rate reimbursed to a nursing home, except where required under s. DHS 132.51 (2) (b). However, if a recipient or the recipient’s legal representative chooses a private room with full knowledge and acceptance of the financial liability, the recipient may reimburse the nursing home for a private room if the following conditions are met: DHS 107.09(4)(k)1.1. At the time of admission the recipient or legal representative is informed of the personal financial liability encumbered if the recipient chooses a private room;