Adoption Medical to Institutional Care PRTF

Children whose adoption has been finalized may require a placement in a Psychiatric Residential Treatment Facility (PRTF). Children can receive these services without re-entering custody and placement in foster care. If the child does re-enter custody and placement in foster care, please see Foster Care Medical to Institutional Care (PRTF).

To Process:

The following steps are utilized when a child receiving HCBS medical has been admitted to a PRTF for a Temporary Stay of less than 30 days or a Long Term Stay of 30 days or more.

  1. Access the case through Person Search or enter the Case Number in the quick search field from Task Navigation and click Go.  The Case Summary page displays.

  1. Click the View Details button in the Medical Programs block. The Medical Detail page displays.

  2. Click the Edit button to make the page editable.

  3. Click the Edit button in the Program Persons section. The Medical Person Detail page displays.

  4. Click the Add button in the Requested Medical Type section. The Requested Medical Type Detail page displays.

  5. Select LTC from the Requested Medical Type drop-down menu.

  6. Enter the Begin Month using the <mm/yyyy> format or the calendar icon.

  7. Click the Save and Return button. The Medical Person Detail page displays.

  8. Click the Save and Return button. The Medical Detail page displays.

  9. Click the Save and Return button. The Case Summary page displays.

  10. Select Customer Information from Local Navigation. The Contact Summary page displays.

  11. Select LTC Data from Task Navigation. The LTC Data List page displays.

  12. Click the Add button. The LTC Data Detail page displays.

  13. Select the child’s name from the Name drop-down menu.

  14. Select Institutional Care from the LTC Type drop-down menu. Additional fields display.

  15. Enter the date the information is being entered in the Recorded Date field using the <mm/dd/yyyy> format or the calendar icon.

  16. Click the Select button under Facility Name/Location in the Facility Placement/Discharge section. The Select Provider Resource page displays.

  17. Enter the facility Name then click the Search button. The Select Provider Resource results page redisplays with search results.

NOTE: If the Facility Name/Location is not found on the first search, try entering a portion of the Facility Name. If the Facility Name/Location is still not found or needs to be updated, see KDHE Licensed and Child Care Centers.

NOTE: Misspelled names may incorrectly limit results.

  1. Click the radio button for the desired provider.

  2. Click the Select button. The LTC Data Detail page displays with Facility information populated.

  3. Select Yes from the Admission Information drop-down menu in the Facility Placement/Discharge section. Additional fields display.

NOTE:  Reference Form MS-2126 Notification of Nursing Facility Admission/Discharge received from the facility to complete the next several steps.

  1. Enter the Admission Date using the <mm/dd/yyyy> format or the calendar icon.

  2. Select the correct value from the Anticipated Length of Stay drop-down menu.

NOTE:  Per PPS policy a temporary stay at a PRTF is considered any time period less than 30 days. A temporary stay can be determined by the Anticipated Length of Stay recorded on the MS-2126. If the Anticipated Length of Stay field on the MS-2126 has a recorded estimate of 30 days or longer the stay is considered a long term placement.  

  1. Select Psychiatric Residential Treatment Facility from the Current Level of Care in Your Facility drop-down menu.

  2. Enter $9000.00 for the Cost of Care in the Facility Placement/Discharge section.

  3. Select Yes from the Care Screening Met drop-down menu in the Care Screening section.

  4. Enter the Date following CARE or Screening Completed recorded on the MS-2126 in the Date Screening Completed field using the <mm/dd/yyyy> format or the calendar icon.

NOTE: If the Date following CARE or Screening Completed on the 2126 is blank enter the admission date in the Date Screening Completed field.

  1. Select Yes from the Discharge Information drop-down menu if the discharge information is known. Additional fields dynamically display.

  2. Select the correct value from the Discharged To drop-down menu and enter the Discharge Date as shown on the MS-2126.

  3. Click the Save and Return button. The LTC Data List page displays.  

  4. Select Run EDBC from Task Navigation. The Run EDBC page displays.

  5. Select the month Institutional Care begins from the Benefit Month drop-down menu.

  6. Click the Select button.

  7. Select the check box for the Medical program.

If the Benefit Month precedes the come-up month

  1. Select Yes from the Timely Notice Exception drop-down menu.

  2. Select LTC Late Change from the Reason drop-down menu.

  1. Click the Run EDBC button. The EDBC List page displays.

  2. Click the Medical hyperlink with Run Status of ‘Not Accepted’. The Medical EDBC Summary page displays.  

  1. Review the information:

NOTE:  If there is an amount in the Premium/LTC/Liability Spenddown, the user should cancel out of the EDBC result and follow the steps in Modify Existing Income. A patient liability is generated when children receiving SSA or SSI benefits were residing in a PRTF at the time they were placed in agency custody. Since FC/AA Medical does not establish patient liability, the income amount needs to be changed to $0.00. The user needs to then re-run EDBC for the Benefit Month to get the $0.00 liability amount.

  1. Click the Adoption Subsidy Medical hyperlink located in the Medical Summary block. The Requested Medicaid EDBC – Adoption Subsidy Medical page displays. Review the LTC Details block to verify the Start Date and End Date are correct.

  1. Click the Accept button if the EDBC results are correct. The EDBC List page displays with a Status of ‘Accepted – Not Saved’.

  2. Click the Save and Continue button. The Distributed Documents page displays with the NOAs (Notices of Action) generated.  

  3. Run EDBC for each month from the LTC change through the discharge month or the come-up month.

  4. Select the check box for the NOA. Click the Delete button. The NOA is removed from the Distributed Documents page.

  5. Set a task if no discharge date was provided for a temporary stay. Select Tasks from Utility Navigation. The Task Management window opens. Click the Add Task button. See Adding a Task.

NOTE:  A task should be set for 30 days from the Admission Date to check the status of temporary care cases. If the child is discharged prior to the 30th day, see Institutional Care to Adoption Assistance Medical or Institutional Care to Foster Care Medical. If the PRTF stay is expected to exceed 30 days, see Institutional Care – Temporary Stay to Long Term Care.

  1. Select Journal from Utility Navigation. Record a Journal entry of the actions taken on the case. See Journal for more information about journaling functionality.