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Rochester New York Form 8815: What You Should Know
In general, it is expected to be a final document; however, it may be used to prepare claims with respect to the resident. A patient's legal representative or an attorney may want to use this document to document a patient's medical condition, or to establish that the conditions of the patient were caused or contributed to by the resident. To use this document in a case where the patient has been discharged from involuntary inpatient care, a case management officer should make contact with the medical staff of the discharge facility. This is the usual first step in resolving a patient or residents medical needs, such as placement in a long term care facility or an individual, family, or community home. The purpose of this form is to document the care that the resident received prior to their involuntary discharge. This form is a non-exhaustive source of documentation for purposes of filing a claim for payment of payments under Part A of the Federal Perkins and Consolidated Health Programs at the facility. This form can be used to document that the resident received care before going into involuntary inpatient care. The hospital's legal representative is not required to attach a copy of this form to the case. However, the resident's legal representative (the legal representative of an involuntary patient who has been declared disabled under the laws of the state) should attach a copy of this form to the case. The State's Medicaid Fraud Control Unit may obtain confirmation from the patient that she or he has already been discharged. If the patient has already been discharged, the State must also inform the patient if the resident was discharged from the facility after August 12, 2009. NOTE: If the facility provides services for a period of time after discharge, the facility should obtain confirmation whether the individual is now receiving the required level of care by contacting the Department's Office of Patient Advocacy by phone, toll-free at (TTY). This form may also be used by the facility to document the patient's receipt of rehabilitative services that are provided while discharged. The hospital's legal representative is not required to attach a copy of this form to the case. However, the resident's legal representative (the legal representative of an involuntary patient who has been declared disabled under the laws of the state) should attach a copy of this form to the case. The State's Medicaid Fraud Control Unit may obtain confirmation from the patient that the resident has been discharged.
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