8115 Resident Status Review

Eligible individuals in Medicaid approved nursing facilities will be reassessed for the need for NF level care on a recurring basis through the MDS assessment. Individuals identified as high functioning and for whom placement in a less intensive HCBS care setting is being sought will be placed in resident status review. The individual must cooperate in this process and accept appropriate care and services that are available in a less intensive setting. Failure to do so will lead to termination of nursing facility payment. The designated case manager will notify agency staff when the need to terminate payment is required and action to do so must be based on timely and adequate notice. Eligibility would also be adjusted accordingly.