Long Term Care

Home and Community Based Services
Special Programs

Katie Beckett - Fact Sheet  Updated 10/20/17

Medicaid Long-Term Care -Fact Sheet - Updated 10/20/17

Money Follows The Person

Olmstead Plan

  • Hospice - A hospice is a public or private organization that provides palliative, rather than curative, care for terminally ill individuals. The care is provided in order to meet the physical, social, psychological, emotional, and spiritual needs of the individual and their family. Hospice services may be provided in the individual's home or within a long term care facility such as a nursing home and is considered to be the residence of the individual. Hospice services in a long term care facility may also be utilized as respite care of the individual for up to five (5) days to provide support to the families.
  • Nursing Homes
  • Pre-Admission Screening and Resident Review (PASRR) - PASRR screening is completed for all nursing home residents prior to admission or for any status change to determine if there are indicators of mental illness and/or mental retardation. This screening is intended to assess whether an individual is appropriate for nursing facility placement. The Level I screening is the first step to determine if there are positive indicators for mental health diagnosis or suspected diagnosis. Those who do not meet the Level I screening are referred for a Level II assessment. The Level II assessment determines if a nursing facility level of care is appropriate and if the individual requires additional mental health services during their nursing facility residency.

Please find below links for two flow charts that diagram the information processes for PASRR Level I and level II providers may find helpful:

PRIOR AUTHORIZATION requirements for Nursing Facilities

NOTICE Effective 4/1/2015, Prior Authorization will be required for all Nursing Facility Claims. PAs are generated by submission of the Pre-Admission Screen. Please find a PowerPoint Presentation from related webinars here.

Here is a quick summary of key points.

Two webinars were recorded.

By DCH: Click here to view and hear the webinar recording

By Hometown Health 

Click the link to view and hear the Webinar recording

Note: You can view the recording on your PC only.