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EAZ
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Revised September 2, 2009 |
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Long-term care |
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Purpose: |
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WAC 388-513-1320 Effective April 10, 2009
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Clarifying Information The term, "institutional status," refers to a minimum period of time for which a client requires LTC services. A client attains this status when the need for inpatient services is equal to or greater than the number of days defined in WAC 388-513-1320. A client who is approved for waivered or hospice services and is receiving such services has also achieved institutional status. Institutional programs in ACES are under the K, C and L track. A client attains institutional status when he/she:
Medical Institutions Not every facility is considered a medical institution. Assisted living, adult family home, boarding home, DDD Group homes are not considered medical institutions, but clients can be receiving an institutional (Waiver) program in these facilities. This is a list of medical institutions: Hospital Institution for the Mentally Diseased (IMD) (Western and Eastern State Hospitals) Intermediate Care Facilities for the Mentally Retarded (ICF-MR) (DDD facilities) Nursing Facility (NF) Veteran's Home-nursing facility section Hospice Care Center Rehabilitation Habilitation Centers (RHC) (DDD facilities) Medicaid Personal Care (MPC) is not considered an "institutional" program.
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Worker Responsibilities Obtain the determination of whether the client is likely to remain institutionalized for 30 consecutive days from the department-designated social worker (SW). For nursing facility cases, the HCS SW notifies financial of the date of request for assessment, whether the client is projected to be in a nursing facility 30 days or more and if the client meets nursing facility level of care (NFLOC). For clients who meet both 30 day or more institutionalization and NFLOC, institutional Medicaid is considered. For clients who do not meet the 30 day or more institutionalization, institutional Medicaid cannot be considered. Eligibility for Medicaid is determined as if the client were in their own home. If the client is eligible for another Medical program, the admission into the medical institution is considered a short stay (30 days or less). SEE SHORT STAYS. | ||
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ACES PROCEDURES See Long Term Care and Waivered Services | ||