The LTC Data Detail page is used to add or edit information received from community partners on the MS-2126, ES-3166, ES-3160 and ES-3161 forms for individuals requesting LTC Medical programs.
Select Eligibility from Global Navigation. Select Customer Information from Local Navigation. Select LTC Data from Task Navigation. The LTC Data List page displays.
If updating an existing record, click the Edit button then skip to step 7 below. To create a new record, continue to step 3.
Click the Add button. The LTC Data Detail page displays.
Select the consumer who needs LTC in the Name drop-down menu.
Enter the date the user is adding the information in the Recorded Date field.
Select the appropriate Type of LTC in the LTC Type drop-down menu. Additional fields display dynamically based on the type of LTC selected.
Complete the section below for the applicable type of LTC.
Click the Save and Return button when all necessary information is recorded.
Procedures for the following living arrangement changes are detailed below:
PACE to Institutional Care – Permanent Stay Out of Network
Discontinuing a Temporary Stay - Existing/Continuing Medical Program
Changing an Institutional Care Temporary Stay to a Permanent Stay
Institutional Care to Institutional Care – Change in Facility
HCBS to Institutional Care - Temporary Stay to Permanent Stay
HCBS to Independent Living - Existing/Continuing Medical Program