Recuperative Care Extended Stay
If the member is close to the 21-day stay limit, providers may request an extension if a member requires recuperative care services for more than 21 days. Providers must submit the Recuperative Care: Extended Stay Request (DHS-8513) (PDF) along with the required medical information for extended stays. Refer to Authorization under Provider Basics in the MHCP Provider Manual to submit a prior authorization request. Extended stays are not expected to go past 60 days.

Readmissions
Any consecutive readmission to recuperative care services for the same diagnosis will continue the same 21-day limit. Any readmission to recuperative care services for a new diagnosis starts a new 21-day coverage limit.

Discharge From Recuperative Care Services
Providers must ensure either one of the following before discharging a member from recuperative care services:

• The member’s medical condition has improved.
• The member is being discharged to another setting that can meet their needs.

Note: The member can choose to be discharged with no housing option if that is their choice.

It is the recuperative care facility’s responsibility to have an established policy for when members may be unwilling to discharge from the facility.