317:35-19-18. Change in level of long-term medical care

(a) When a member is receiving Personal Care services and requests nursing facility care, a new Uniform Comprehensive Assessment Tool (UCAT) is required. No new medical decision is needed for admission to a nursing facility from home if the period of absence from the nursing facility is less than 90 days. No new medical decision is needed if the member loses financial eligibility but maintains medical eligibility by having a current medical decision and by remaining in the facility during the period of financial ineligibility.

(b) When there is a decision that a member approved for one level of long-term care is eligible for a different level of care, the local office is advised by update of the file.