Skilled Nursing Facility: Covered Services for KanCare Members
Date: 11/02/20
Sunflower Health Plan would like to remind our skilled nursing facility (SNF) providers of the covered benefits for KanCare members.
If you are contracted with Sunflower for your SNF services, Medicaid covers skilled nursing care at Medicaid-certified skilled nursing facilities. Medicaid covers skilled nursing facility care and services such as nursing services, rehabilitative services, pharmaceutical services, medical social services, meals and other care.
The KMAP nursing facility program provides room, board and all per diem services and supplies required for residents in a nursing facility (NF).
- NFs are facilities that meet state licensure standards and provide health-related care and services, prescribed by a physician, to residents who require 24-hour-a-day, seven-day-a-week, licensed-nursing supervision for ongoing observation, treatment or care for long-term illness, disease or injury.
- NFMHs (nursing facilities for mental health) are facilities that meet state licensure standards and provide health-related care and services, prescribed by a physician, in conjunction with recommended active treatment programming for residents with a diagnosis of mental illness or behavior disorders.
- ICFs-IIDs (intermediate care facilities for individuals with intellectual disabilities) are facilities that meet state licensure standards and provide habilitation-related care and services, prescribed by a physician, in conjunction with active treatment programming for beneficiaries who have intellectual disabilities and related health and physical conditions.
Medicaid does not cover assisted living or continuing-care retirement communities (with the exception of skilled nursing units).
Provider Resources
- Sunflower Provider Manual
- Sunflower Health Plan provider communication related to Skilled Nursing Facility services:
- KMAP Provider Manuals for the most current manual type select Nursing/Intermediate Care Facility