P1010 Moving Customers to ALTCS Transitional
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P1010 Moving Customers to ALTCS Transitional

 

Program

Manual Section

ALTCS

MA1010

 

Procedure

Follow the steps below when a customer is scoring in the ALTCS transitional range at PAS reassessment:

NOTE     This process is intended for use by PAS Assessors.

Step

 Action

1

Is the customer living in an NF or ICF-IID?

  • If NO, STOP. Inform the case manager of the change in the customer’s level of care. Inform the financial worker and the customer or representative of the change in eligibility. Close the PAS.

  • If YES, request a Physician Review and continue to step 2.

2

Does the Physician Review show that the customer is still eligible for full ALTCS?

  • If YES, STOP. Close the PAS as eligible. Notify the customer, representative, case manager and SNF of the determination.

  • If NO, continue to step 3 to process the change to ALTCS Transitional.

3

Consult the case manager regarding the change in the customer’s level of care and the need to start discharge planning.

4

Inform the customer, representative, and NF or ICF-IID of the change to ALTCS Transitional.

5

Close the PAS.