Section 210-RICR-50-05-1.1 - Overview and PurposeA. Medicaid covers certain inpatient, comprehensive services, subacute and long-term services and supports as institutional? benefits. The word "institutional" with respect to federal Medicaid? requirements applies to benefits authorized under Title XIX of the federal Social Security Act. For the purposes of LTSS, Medicaid recognizes three distinct health institutions all of which must be licensed under State law - nursing facilities (NF), intermediate care facilities for persons with intellectual or developmental disabilities (ICF/I-DD), and long-term care hospitals (LTH), including psychiatric care facilities for children and youth under age twenty-one (21), and the Eleanor Slater Hospital. In Rhode Island, these institutions are licensed by the Department of Health as "health care facilities" under R.I. Gen. Laws Chapter 23-17.B. The characteristics of health institutions for Medicaid LTSS coverage purposes are as follows: 1. They operate as residential facilities and assume total care of a person who is admitted.2. The comprehensive care provided includes room and board. Medicaid LTSS provided in a home or community-based setting is specifically prohibited under Title XIX from covering room and board.3. The comprehensive services health institutions provide are billed and reimbursed as a single bundled payment. The State may vary the services included as part of the bundled rate across institutions. Therefore, a covered service included as part of a bundled rate in one institutional setting may be billed as a separate service in another setting.4. Medicaid payment is only available if the State licensed or certified health institution meets applicable federal standards to qualify for federal financial participation under the Medicaid State Plan.5. Health institutions are subject to regulatory oversight, including surveys at regular intervals, to maintain their certification, license to operate, and status as Medicaid providers; and6. The rights and safety of patients and residents are protected in accordance with Title XIX of the Social Security Act at 42 U.S.C. §§ 1902(i), 1902(y) and 1919(h) and R.I. Gen. Laws Chapter 23-17-19.1.210 R.I. Code R. 210-RICR-50-05-1.1