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 on the Task Navigation menu. The LTC Data List page displays.
Click the Edit button for the current PACE record.
Click the Edit button on the LTC Data Detail page in the Complete for Current PACE Enrollees block.
Complete the Current PACE Enrollees section:
Enter the Discharge Date field using the <mm/dd/yyyy> format or the calendar icon.
Select 30 days or more from the Anticipated Length of Stay drop-down menu.
Select Yes from the Voluntary Disenrollment drop-down menu.
Enter the last day of the Temporary Stay in the Effective Date field using the <mm/dd/yyyy> format or the calendar icon.
Enter a note in the Reason box stating admit Out of Network permanent stay.
Click the Save and Return button. The LTC Data List page displays.
Select 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.
In the Facility Information block, 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.
Select Yes next to the Admission Information field.
Enter the Admission Date as the last day of the Temporary Stay from PACE 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.
Select 30 days or more from the Anticipated Length of Stay drop-menu.
NOTE: The Admitted From Hospital requires the Previous Admission Date. This date is used when determining the Community Spouse Resource Allowance. If a Community Spouse Resource Allowance is not being completed, do not select Hospital. This field can be left blank.
Select the Current Level of Care in Your Facility using the drop-down menu.
Enter the Cost of Care.
NOTE: For the Cost of Care use the Nursing Facility daily rate (from MMIS or KDADS) x 31 days if the stay is more than 30 days. For PRTF Cost of Care use $9000.00.
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.
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 permanent stay begins. The Run EDBC page displays. See Running EDBC for detailed steps.
Select the Benefit Month the permanent stay begins from the drop-down menu then click the Select button.
Select the program using the check box. If the month the permanent stay begins is not the come-up month, 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 information is incorrect the user needs to correct the LTC Data Detail page(s).
Click the Close button to close the window. 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.
Run EDBC through the come-up month to high date the new eligibility. See Running EDBC for detailed steps. For months prior to the come-up month, select Yes for a Timely Notice Exception and a Reason of LTC Late Change.
Send Notices as appropriate. See Manual NOA Generation, Generating a Form for an Institutional Care Facility, and ES-3166 Notification of Pace Information for detailed steps on sending notifications.
Select Journal from Utility Navigation. Record a Journal entry of the actions taken on the case. See Journal for more information about journaling functionality.