Class Code: 8829
Per NCCI's Scopes Code Description:
Code 8829 utilizes various descriptive phraseology such as “Convalescent or Nursing Home” “Home for Aged,” “Nursing Home” and “Rest Home.” Notwithstanding these descriptions, this classification is applicable to “all employees,” both professional and nonprofessional, of those risks which provide medical care and daily living assistance to the aged and/or infirm. As the term “all employees” does not include Standard Exception Codes 7380, 8810 and 8742, these classifications may also apply to a Code 8829 risk if these exposures exist.
Retirement living centers, which are described in the latter portion of this scope, are classified to Codes 8824, 8825 and 8826.
Insureds classified to Code 8829 provide various levels of health care depending on the patients’ needs. The extent of professional or medical services provided by these health care providers includes complete medical care for postoperative patients and patients requiring extensive nursing care due to various illnesses such as terminal cancer, kidney disorders and heart disease as well as facilities where the patients require only minimal medical or professional care.
These health care facilities usually do not employ resident physicians, although they usually have arrangements wherein physicians are on call for emergencies. In some states, the licensing authority requires registered nurses to be on duty. Generally these homes will primarily employ therapists, practical nurses, nurses’ aides and orderlies to afford the necessary medical care to their patients. The homes also may employ cooks, waitresses, maids, maintenance personnel, social workers and recreational directors.
Homes for the aged are assigned to the convalescent or nursing homes classification because of the operational similarity to convalescent or nursing homes. These homes function primarily to care for people who, due to illness, physical infirmity or advanced age, are unable to care for themselves and therefore require health care.
Other establishments that are not classified to Code 8829 but do cater to persons who have attained an advanced age are nursing or convalescent homes operated in conjunction with a hospital classified to Codes 8833 and 9040, and retirement living centers (RLCs) classified to Codes 8824, 8825 and 8826.
Retirement living centers (RLCs) are housing establishments that cater to the elderly population and offer a continuum of health care services. RLCs may vary from sprawling one-story to multi-story buildings or to cottages surrounding a central facility. The health care services offered typically include congregate, personal and nursing or medical care services. Congregate services include, but are not limited to, meal service, linen service, housekeeping and transportation. Personal care services, sometimes referred to as assisted living care, include assistance with daily living activities such as, but not limited to, ambulation, bathing and dressing. Nursing or medical care includes physical therapy as well as the administration of drugs, preparations or medications.
Retirement living centers (RLCs) are distinguished from Code 8829 risks by the fact that RLCs are similar to typical rental or condominium-type housing complexes with the exception that medical and other personal assistance is available for those in residence. Risks classified to Code 8829 provide living conditions typically found in a dormitory or hospital-like environment. Stated differently, the RLC provides a “home-type” environment as opposed to the “institutional-type” environment of the risk classified to Code 8829. As a group, RLC residents will generally require less care or personal services than those occupants of convalescent or nursing homes classified to Code 8829. RLCs are further distinguished from convalescent homes by the fact that RLCs are not expected to provide twenty-four-hour nursing care to individual building residents as is typically found in convalescent or nursing home operations.
If an insured qualifies as an RLC, convalescent or nursing home operations performed in conjunction with the RLC are not separately rated but are assigned to the RLC classifications. “Conjunction,” as used in the preceding sentence, refers to facilities at the same location. These facilities may have a common kitchen, maid service and maintenance employees. A nursing home located away from an RLC that operates without interchange of labor with the RLC is separately rated.
This procedure is followed no matter which classification predominates. The aforementioned is intended to preclude an enterprise operating a minimal amount of units to consider itself an RLC in order to avoid the assignment of nursing or convalescent classes to its business. An enterprise that considers itself an RLC must meet the requirements for these classifications as described in paragraph one of this scope.
(FL) State Addendum: Refer to Code 8841—Nursing Home—Professional Employees and Code 9047—Nursing Home—All Other Employees for nursing homes.
(MA) State Addendum: Refer to Codes 8833 and 9040 for rest home operations. Refer to Codes 8824 and 8826 for qualifying assisted living residences. Nursing homes operated in conjunction with a qualifying assisted living residence are assigned to Code 8829. In this context, “conjunction” means that the assisted living residence and the nursing home facility are at the same location and both facilities are owned and operated by a single insured entity.
Apartments or residential complexes known as continuing care retirement communities are to be classified in accordance with all applicable MA Manual Rules as follows: Code 9015 for residences with no services other than building maintenance and security; Code 8826 for residences that provide services such as meals, laundry, housekeeping, and transportation without personal care assistance; Code 8829 for nursing home accommodations; Code 8824 and Code 8826 shall apply to residences that provide personal care assistance with activities of daily living and/or medication administration in addition to providing services such as meals, laundry, housekeeping and transportation (Code 8825 is N/A MA).