Provider Information

Changes in Long-term Care Assessment Program

Changes in Long-term Care Assessment Program (Word* | also in PDF*)

To:

Interested Parties

From:

Christine Gianopoulos

Date:

September 9, 2003

Subject:

Changes in Long-term Care Assessment Program

Budget constraints affecting the Bureau of Elder and Adult Services and the Bureau of Medical Services have made it necessary to alter assessment program practices. These changes are intended to make best use of limited assessment funds. We regret having to restrict access to assessments, but hope that when the budget situation improves we may again offer expanded access. The changes are as follows:

Nursing Facility: MaineCare residents now receive an extended eligibility (24-month) date at the first nursing facility level of care re-assessment after admission, unless the assessor anticipates the resident's condition may change. MaineCare-eligible residents returning from a hospital stay no longer require an assessment, unless their bed-hold has expired.

Residential Care Facility: Some residential care facilities request multiple assessments on the same individual. It is not financially feasible to continue this practice. Effective immediately, persons living in a residential care facility may have one assessment. Subsequent requests within the same fiscal year will be honored only if the facility is planning to discharge the resident to another care setting.

Home Based Care Program: Effective immediately, assessments for individuals seeking services under this program are deferred. Given the current waiting list of 700+ persons, it is not a good use of limited funds to assess persons whose condition is likely to change between the time they are assessed and when they can be admitted to the HBC program. Goold Health Systems will offer an extended telephone screening; make referrals to other services, such as Homemaker, Alzheimer's Respite, Adult Day Services, or Family Caregiver; and provide the same written information that now is given at the face-to-face assessment.

Hospital Assessments: Assessments for persons being discharged to residential care or assisted living are not required. Patients being discharged home who are eligible for MaineCare home care services will be assessed after discharge and, if applicable, when Home Health services end. Conducting the assessment in the home gives the assessor a better picture of the person's needs, strengths, and environment.

MaineCare Services: Requests for assessments for MaineCare nursing facility and home care will continue to be honored.

Advisory Assessments: Will be available to individuals who are actively seeking nursing facility placement and have identified a facility; who are converting to private pay at the end of a SNF stay, or have been prescreened as potentially eligible for a MaineCare program.

If you have questions, please contact Mollie Baldwin at 287-9200, or by e-mail at Mollie.Baldwin@maine.gov.