Assistive Care Services and Assisted Living for the Elderly Waiver
Assistive Care Services and Assisted Living for the Elderly Waiver
Assistive Care Services and Assisted Living for the Elderly Waiver
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<strong>Assistive</strong> <strong>Care</strong> Service <strong>and</strong> <strong>Assisted</strong> <strong>Living</strong> <strong>for</strong> <strong>the</strong> <strong>Elderly</strong> Wavier <strong>Services</strong><br />
Coverage <strong>and</strong> Limitations H<strong>and</strong>book<br />
Leave of Absence <strong>and</strong> Discharge<br />
Introduction<br />
Medicaid recipients must reside in an ACS-enrolled facility in order to<br />
receive ACS services. A recipient that is not a resident of an ACS-enrolled<br />
facility will be denied ACS services even if all o<strong>the</strong>r eligibility criteria are met.<br />
A recipient may be terminated from ACS, under some circumstances, when<br />
moving from one facility to ano<strong>the</strong>r. Recipients must be advised of <strong>the</strong>ir rights<br />
to appeal <strong>the</strong>se actions when <strong>the</strong>y occur.<br />
Note: See Part I, Chapter 3, Appendix B of this h<strong>and</strong>book <strong>for</strong> fair hearing<br />
process in<strong>for</strong>mation.<br />
Leave of Absence<br />
Recipients may leave <strong>the</strong> facility <strong>for</strong> more than 24 hours from time to time <strong>for</strong><br />
health or personal reasons. During such periods, <strong>Assistive</strong> <strong>Care</strong> <strong>Services</strong> are<br />
not being provided <strong>and</strong> may not be billed.<br />
ACS Discharge<br />
Requirements<br />
If <strong>the</strong> ALF, AFCH, or RTF representative initiates discharge of an ACS<br />
recipient, <strong>the</strong> discharge must be done in accordance with <strong>the</strong> licensure<br />
requirements applicable to <strong>the</strong> facility type.<br />
Move to Ano<strong>the</strong>r<br />
ACS Provider<br />
If <strong>the</strong> recipient requests to move or is moved from one ACS-enrolled facility<br />
to ano<strong>the</strong>r ACS-enrolled facility, <strong>the</strong> discharging facility representative will<br />
assist in coordinating <strong>the</strong> placement, <strong>and</strong> <strong>the</strong> recipient will remain eligible to<br />
receive ACS in <strong>the</strong> new facility.<br />
The discharging facility may not bill <strong>for</strong> <strong>the</strong> day of discharge. The admitting<br />
facility may bill <strong>for</strong> <strong>the</strong> day of admission.<br />
Any time a change in facility is necessary <strong>for</strong> a recipient who receives<br />
Optional State Supplemental (OSS) payments, <strong>the</strong> change must be<br />
coordinated with <strong>the</strong> recipient’s DCF case manager.<br />
July 2001 2-14