Short Stay
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Short Stay


Revised October 11, 2011



What is a short stay?

 

How long can a short stay be?

 

When is it appropriate to enter a short stay?

 

How do I enter a short stay?

 

What if a short stay spans multiple months?

 

How is participation assigned to a short stay provider?

 

How do I view participation assigned to a short stay provider?

 



What is a short stay?

 

·         A short stay is when a client enters a medical facility or elects Hospice services for a short time frame. For additional information, see EAZ Manual Long Term Care – Short Stays – Temporary Admissions into Medical Facilities.

 

·         Financial workers usually learn about short stays after they have ended and the clients have returned to their regular living situation.

 

How long can a short stay be?

                    

·         Up to 29 days for:

 

o    Clients who meet institutional criteria (L-track and K-track). See EAZ Manual – WAC 388-513-1320 Determining institutional status for long-term care (LTC) services.

 

o    Clients who meet non-institutional rules medical rules.

 

o    Clients who are active in an Aged, Blind, & Disabled (ABD) AU.

 

·         Up to 90 days for:

 

o    Clients who meet non-institutional rules active in a TANF or RF AU.

 

¨        Policy allows 180 days, however, at this time ACES only allows 90 days. See EAZ Manual – WAC 388-454-0015 Temporary absence from the home for more information.

 

When is it appropriate to enter a short stay?

 

·         Short stay data can only be entered for:

 

o    Active medical recipients.

 

o    After the short stay has ended.

 

o    In a historical month.

 

o    Stays in a medical institution or for hospice services.

 

o    Clients who return to their original setting when the short stay ends.

 


EXAMPLE

Client resides in an Adult Family Home (ALH) and is admitted to a nursing home for two weeks. The client returns back to the same AFH. This situation should be coded on the STAY screen.


EXAMPLE

Client resides at home and is active on an S02 AU. Client admits to a nursing home for three weeks. The client returns home. This situation should be coded on the STAY screen.


EXAMPLE

Client resides in a nursing facility, and has a medical condition requiring hospitalization. The client discharges from the nursing facility and enters the hospital. After two weeks, the client enters a new nursing facility. This situation should be coded on the INST screen because the client entered a different nursing facility.


EXAMPLE

Client resides in an Assisted Living Facility (ALF), and has a medical condition that requires a stay in a Nursing Facility or Hospital for over 29 consecutive days. Client then returns to the same ALF. This situation should be coded on the INST screen.


How do I enter a short stay?

 

1.    On the AMEN, select Option R – Interim / Hist Change.

 

o    Enter the [month the short stay began] in the Benefit Month field.

 

2.    On the STAY screen:

 

o    Enter the [short stay living arrangement type] in the Liv Arr field.

 

o    Enter the [medical facility subset valid value or H – Hospice] in the Type INST/HCBS field.

 

o    Enter the [provider id number] in the Provider ID field.

 

¨        HS – Hospitals, IM – Institutions for Mentally Diseased and MR – Community IMR or RHC (State IMR) do not have provider numbers.

 

o    Enter the [entry and leave dates] in the Stay Date fields.

 

¨        The Entry Date must be for the benefit month being processed.

 

¨        The Leave Date cannot be prior to the Begin Date and can’t exceed the current date.

 

¨        If the short stay spans 2 benefit months, the Leave Date can be a future benefit month, provided the dates do not exceed the short stay time limits for the program.

 

¨        When multiple stays exist, the dates cannot overlap, except in the following situations:

 

·         The Leave Date of one short stay is equal to the Entry Date of the next stay.

 

·         Hospice services as a short stay in a medical facility can be coded concurrently with an institutional stay when the client has elected Hospice services while in an institution.

 

·         Hospice service data must be entered in the Home Community Based Service (HCBS Type – H): section as a separate entry from the institutional data in order to capture rates for each provider.

 

o    Enter the [payment authorization date] in the Pymt Auth Dt field.

 

¨        If no Pymt Auth Dt is entered, no participation is assigned to the short stay provider.

 

o    Enter the [daily state rate] in the State Rate field.

 

¨        This field is required for all clients who meet institutional criteria. See EAZ Manual – WAC 388-513-1320 Determining institutional status for long-term care (LTC) services.

 

3.    Call DONE and commit the data.

 

·         ACES generates the following letters for authorized short stays:

 

o    For K or L-track clients – either Letter 002-17 (Approval for LTC Services) or Letter 002-18 (Approval for Hospice Services) based on the type of stay.

 

o    For non-institutional and I-track clients – Letter 002-32 (Approval for Short Stays).

 

¨        This letter is addressed to the client for whom the short stay was entered, regardless of the client’s age or whether or not the client is the Head of Household (HOH).

 

¨        This letter does not generate for hospital short stays.

 

¨        If this letter is generated for a D01 or D02 AU it will only be viewable in aces.online for Foster Care Unit workers.

 

o    A separate letter generates for each individual stay, unless the stays are for the same provider.

 

What if the short stay spans multiple months?

 

·         When a short stay spans multiple months, the stay must be entered in the month in which the stay begins.

 

·         The short stay data does not have to be re-entered in the following months.

 

·         Eligibility must be manually recalculated (using the Calc Elig Ind indicator on the MISC screen) in order to recalculate participation for each month impacted by the stay. See <F2> Help.

 

How is participation assigned to a short stay provider?

 

·         ACES calculates client cost-of-care responsibility based on data entered on the STAY screen and the clients circumstances.

 

·         Participation is only assigned to short stays with a Payment Authorization Date entry.

 

·         Participation is assigned first to providers coded on the INST screen and if there is any remaining participation, it is assigned to the short stay providers.

 

How do I view participation assigned to a short stay provider?

 

·         To view participation assigned to a short stay provider, take the following steps:

 

1.    On the AMEN, select Option B – AU/Client Inquiry.

 

o    Enter the [CLID number] in the Client ID field and the [benefit month the short stay began] in the Benefit Month (MM YY) field.

 

2.    On the STAY screen:

 

o    Enter a [Y] in the Sel field next to the short stay to be viewed.

 

o    Press <F13> and the SSCC screen displays.

 

o    The SSCC screen displays the following fields for 1, 2 or 3 months, depending on the length of the short stay: 

 

¨        Room & Board

 

¨        Third Party Resources

 

¨        Participation

 

¨        Total Payment

Modification Date: October 11, 2011