Assistive Care Services and Assisted Living for the Elderly Waiver

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Assistive Care Service and Assisted Living for the Elderly Wavier Services Coverage and Limitations Handbook Service Plans for ALF and AFCH Residents, continued Service Documentation The ALF or AFCH must document that recipients received services in the facility on each day for which ACS is billed. There is no required format for such documentation. Note: See Part I, Appendix E for the Optional Service Plan Log Form that can be used for this purpose. Service Plan Review The service plan must be reviewed and updated to reflect the current needs of the recipient. The service provider must monitor the service plan for continuity of services and determine if changes in the recipient’s status warrant changes in the service plan. New Service Plan A new service plan is required on an annual basis or sooner if a significant change in the recipient’s condition occurs. The new service plan must be completed no more than 15 days after the re-assessment required above. ACS Records In addition to records required by the applicable licensure standards, ACS records that must be kept include: • Copies of all eligibility documents, ( i.e., DCF OSS Notice of Case Action, or Medifax strip) • Health Assessment Forms (DOEA Form 1823 or 1110) and reassessments forms; • Assistive care service plan with updates, if any; and • Copy of daily roster or other daily service documentation. This documentation must be maintained at the facility, kept for at least five years and be made available to Medicaid staff or its designated representative upon request. Note: See Chapter 2 of the Medicaid Provider Reimbursement Handbook, HCFA 1500 and Child Health Check-Up 221, for additional information about documentation requirements. July 2001 2-10
Assistive Care Services and Assisted Living for the Elderly Wavier Services Coverage and Limitations Handbook Service Plans for ALF and AFCH Residents, continued ACS Record Documentation ACS documentation must be in ink and must be legible. No erasures or white out are permitted. In case of an error, the ALF administrator or designee, or AFCH provider must line through the error, initial and date it, then make the correct entry. Service Plan Approval Impasse and Fair Hearing Rights If the either the recipient, guardian or representative does not agree with the service plan, and resolution cannot be reached, the service provider must provide the recipient with instructions on the fair hearing process and assist the recipient with preparing for the fair hearing. If the service provider has any in-house grievance process, the recipient’s rights to a fair hearing cannot be replaced by the in-house grievance process. Note: See Part I, Chapter 3, Appendix B of this handbook for fair hearing process information. Assessments for RTF Residents Initial Assessment If the need and eligibility for ACS commence with admission to the RTF, the initial assessment completed pursuant to Chapter 65E-4.016(9), F.A.C., meets the assessment requirement for ACS. If the need and eligibility for ACS commence after admission to the RTF, an assessment following the same procedure as for re-assessment must be completed prior to billing for ACS. July 2001 2-11
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Assistive Care Services and Assisted Living for the Elderly Waiver

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