On May 28, Provider Magazine released an article on Establishing a Bariatric Unit in a Post-Acute Setting. The article identifies areas for consideration for bariatric units in nursing facilities including equipment, an assessment of the built environment as well as staffing. The placement of bariatric patients in nursing facilities in the Commonwealth continues to be a throughput challenge for hospitals. There is an identified need for more bariatric beds to accommodate this population in the long-term care setting. To address the need for additional specialty services, as part of the Rate Year 2024 Medicaid rate regulation, beginning February 2, 2024, MassHealth issued Nursing Facility Bulletin 184 implementing a $300 per member per day bariatric rate add on for MassHealth residents. This new add on is available for all nursing facilities for whom MassHealth is the primary payer and when all of the following conditions are met:
- Prior to the member’s admission, the facility must receive approval from MassHealth to bill the add-on based on the clinical profile of the member;
- The member has a Body Mass Index (BMI) greater than 40 that can be supported by an ICD-10 code after admission;
- The member is dependent, as defined by Minimum Data Set (MDS), for at least one activity of daily living listed in 130 CMR 456.409(B): Assistance with Activities of Daily Living; and
- The member requires a minimum of two staff members to assist with transfers, personal care, and/or bed mobility.