Assistive Care Services and Assisted Living for the Elderly Waiver

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