Assistive Care Services and Assisted Living for the Elderly Waiver

Assistive Care Services and Assisted Living for the Elderly Wavier Services
Coverage and Limitations Handbook
Case Management Documentation
Case Records
A case record must be kept by the case manager for every recipient
receiving ALE waiver services. The purpose of keeping this record is to
assure that information regarding the recipient’s condition and service
provision is contained and available for review at a single location. It is the
basis of the recipient’s plan of care and the basis for quality assurance
monitoring.
The case manager is responsible for developing and maintaining the case
record. The case manager must record all case management activities in the
case narrative including:
• Copies of all eligibility documents;
• Assessments;
• Plans of care, including accurate cost projections;
• Case narratives; and
• Affirmation of receipt of fair hearing rights.
Case records are maintained by the case management agency at a central
location.
Note: See Chapter 2 of the Medicaid Provider Reimbursement
Handbook, Non-Institutional 081, for additional information about
documentation requirements.
Case Narrative
Requirements
All case management activities must be recorded in the case narrative.
• The narrative must be clear and comprehensive, reflecting what the case
manager has done to meet the needs identified in the plan of care.
• There should be documentation of any information that the case manager
has learned about the activities of others on behalf of the recipient.
• The case narrative should also contain a record of the case manager’s
observations of the recipient’s status and must be sufficient to justify
payment.
July 2001 5-5