NOTE: Change the consumer’s mailing and physical address to the facility’s address. See Contact Summary for information on updating an address.
Select Eligibility from Global Navigation. Select Customer Information from Local Navigation. Select LTC Data from Task Navigation. The LTC Data List page displays.
Click the Edit button for the HCBS record that is ending. The LTC Data Detail page displays.
Review the HCBS Information section:
Enter the Admission Date to the facility in the Nursing Facility Admission Date field.
Select 30 days or more from the Anticipated Length of Stay drop-down menu.
Select Yes from the HCBS Terminated drop-down menu.
Enter the Nursing Facility Admission Date in the HCBS Termination Effective Date field.
Click the Save and Return button. The LTC Data List page displays.
Click the Add button to complete the Institutional Care record. The LTC Data Detail page displays.
Select the consumer name from the Name drop-down menu.
Select Institutional Care from the LTC Type drop-down menu.
Enter the date the information is being recorded in the Recorded Date field using the <mm/dd/yyyy> format or the calendar icon.
Complete the Facility Information section.
To select the correct Facility Name/Location, click the Select button. The Select Provider Resource page in the Resource Databank displays. To search for and select the correct Facility Name/Location:
Enter the Provider ID using the Active Nursing Facility (NF) List .
Select Active under Status.
Click the Search button.
NOTE: If the Agency or Provider is not found or needs to be updated, see Requesting an Addition or Change to the Resource Databank.
Click the radio button for the desired Facility Name/ Location.
Click the Select button. The provider selected populates on the LTC Data Detail page.
Select Yes from the Admission Information drop-down menu.
Enter the Admission Date using the <mm/dd/yyyy> format or the calendar icon.
Complete the required fields using MS-2126 Notification of Facility Admission/Discharge received from the facility.
Enter an Admission Date using <mm/dd/yyyy> format or the calendar icon.
Select 30 days or more from the Anticipated Length of Stay drop-down menu.
NOTE: The Admitted From Hospital requests the Previous Admission Date. The Previous Admission Date is used to determine the Community Spouse Resource Allowance start date.
Select the Current Level of Care in Your facility using the drop-down menu.
Enter the Cost of Care.
NOTE: The amount used for the cost of care depends on the situation.
If income does not meet the 300% rule on HCBS cases, use $9,999 as the Cost of Care for HCBS unless a different amount is provided.
Use the Cost of Care provided on the ES-3160 or ES-3161 when income meets or exceeds the 300% rule on HCBS cases. HCBS cannot be set up until the Cost of Care is received in these situations. ·
For PRTF Cost of Care use $9,999.
Complete the CARE Screening information using the provided information from KDADS. Under Care Screening, select Yes if the consumer meets the CARE Screening requirements, if they do not meet the CARE Screening requirement select No. Enter the Date Screening Completed using the <mm/dd/yyyy> format or the calendar icon.
In some situations the consumer may be exempt from a CARE Screening. In this scenario the user should enter Yes for CARE Screening Met and the date the consumer became exempt from the screening requirement. Record this information in the Journal.
NOTE: If the facility did not complete the CARE Screening timely, but the consumer is still eligible for Medicaid, please contact the help desk for processing instructions.
If allocating income complete the Dependents of LTC/Applicant/Member or Dependents of Spouse block. See Income Allocation for more information.
Click the Save and Return button when all necessary information is recorded. The LTC Data List page displays.
Select Run EDBC from Task Navigation to run EDBC for the month the change occurs. The Run EDBC page displays.
Select the Benefit Month the change takes place from the drop-down menu then click the Select button.
Select the program using the check box. Select Yes for a Timely Notice Exception and a Reason of LTC Late Change then click the Run EDBC button.
Click the Medical hyperlink with a Run Status of Not Accepted on the EDBC List page. The Medical EDBC Summary page displays.
Click the Eligible Budgets hyperlink to check that the LTC Details have accurate start and end dates. If the dates are incorrect the user needs to correct the LTC Data Detail page(s). Also note: KEES sends the lowest liability amount for the month to MMIS.
Click the Close button. The Medical EDBC Summary page displays.
Click the Accept button if the EDBC Result is correct. The EDBC List page displays.
Click the Save and Continue button.
Select Run EDBC from Task Navigation. The Run EDBC page displays.
Run EDBC through the come-up month to high date the new eligibility. See Running EDBC for detailed steps. Select Yes for a Timely Notice Exception and a Reason of LTC Late Change.
Send Notices. See Manual NOA Generation and Generating a Form for an Institutional Care Facility for detailed steps on sending the notifications.
Create a Journal entry documenting the changes.