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Effective: October 1, 2008 |
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23.05ar3 - Long-Term Care Consultation (LTCC) (Archive) |
Archived: August 1, 2009 |
The primary purpose of the Long-Term Care Consultation (LTCC) program is to prevent or delay nursing or certified boarding care facility placements. Long-Term Care Consultants also perform preadmission screening (PAS) of all individuals seeking admission to a long-term care facility, as required under state and federal laws.
Waiver Program or Alternative Care (AC) Service Eligibility.
In most cases, an LTCC refers to an in-person visit that determines the level of care a client needs by assessing his or her health and psychosocial needs.
Preadmission Screening, however, is most often completed by telephone communication between the LTCC staff and another health care professional seeking to admit a client to a facility.
The LTCC assessment and the PAS processes are defined by the Aging and Adult Services Division of DHS.
Refer people to the county LTCC team if they are:
l Seeking admission to a nursing facility or certified boarding care facility.
l Applying for:
n Long-Term Care (LTC) coverage.
n Elderly Waiver (EW).
n Alternative Care (AC).
n Community Alternatives for Disabled Individuals (CADI).
n Community Alternative Care (CAC).
n Traumatic Brain Injury (TBI).
People may choose between community-based and facility care.
Note: MA will not pay for nursing or certified boarding care for people who choose to enter a facility when the county LTCC team has determined that the person does not meet nursing or boarding facility level of care criteria.
The county LTCC team:
l determines whether the person needs a nursing facility or certified boarding care facility level of care by assessing the person's health and psychosocial needs.
l helps the person develop a community support plan if they choose community-based services.
l must inform people of available alternatives to institutionalization and recommend either a facility placement or community-based care.
l enters risk status on the LTC Screening Document subsystem in MMIS.
l documents that the person meets EW, CADI, CAC, TBI, or AC service eligibility on the LTC Screening Document.
MA will not pay for EW, CAC, CADI, or TBI services provided prior to the completion of the LTCC in-person assessment and program eligibility determination, as indicated on the LTC Screening Document in MMIS under the Assessment Result date. State-funded AC service payments are also effective as of the Assessment Result date.
Verify that MA applicants or enrollees either have had or are exempt from preadmission screening before admission.
MA will not pay for nursing facility or certified boarding care services received before the Assessment Result date indicated on the LTC Screening Document.