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Medical Services Policy Manual, Section H

H 400 Post Eligibility

Death or Discharge Upon notification from the facility reporting the death or discharge of a recipient, the County Office will initiate action to close the recipient’s case. Advance notice is not required for closure due to death. Home Visits A recipient receiving Long-Term care services has the right to make overnight home visits whenever they desire, provided the visits are consistent with the recipient’s required level of care and their attending physician’s orders. This includes authorized home visits during the thirty (30) days in which institutional status is achieved.

The DPSQA Office of Long-Term Care is responsible for monitoring recipient home visits and their consistency with the patient’s required level of care. For example, a skilled care patient who makes overnight home visits might require reclassification action by Long-Term Care. Facility services may continue during a recipient’s absence due to therapeutic home visit without regard to the cumulative number of days absent during a calendar year. However, a fourteen (14) consecutive day limit is placed on each home visit for payment purposes. Home visits of less than fourteen (14) days will not be reported by facilities to the County Office. The date left counts as the first day of absence. When there is an indication that the recipient is expected to return to the facility within fourteen (14) days, the County Office will take no action. For home visits, which exceed fourteen (14) consecutive days, facilities will report the date left and a discharge on the fifteenth consecutive day of absence. When there is no indication that the recipient is expected to return to the facility within fourteen (14) days, the County Office will initiate action to close the case. • Cases suspendedor closed can be reinstated without new application if the recipient returns to the facility within ninety (90) days of the date left on home visit. • If the reevaluation falls dueduring the period of suspension, it will not be completed until the client reenters the facility. • If the individual does not reenter the facility within ninety (90) days, a new application will be required to reopen the case.