016.06.71-212.400. Temporary Absences from the Home
AR ADC 016.06.71-212.400Arkansas Administrative CodeEffective: October 1, 2022
Effective: October 1, 2022
Ark. Admin. Code 016.06.71-212.400
016.06.71-212.400. Temporary Absences from the Home
Once an ARChoices eligibility application has been approved, waiver services must be provided in a home and community-based services setting for eligibility to continue. Unless stated otherwise below, the DCO must be notified immediately by the DHS PCSP/CC Nurse when waiver services are discontinued and action will be initiated by DCO to close the waiver case. Providers will be notified by the PCSP/CC Nurse.
A participant cannot receive waiver services while in an institution. The following policy applies to any inpatient stay where Medicaid pays the facility for the date of admission, i.e., hospitals, nursing homes, rehab facilities, etc., for active waiver cases when the participant is hospitalized or enters a nursing facility for an expected stay of short duration.
1. When a waiver participant is admitted to a hospital, DCO will not take action to close the waiver case unless the participant does not return home within 30 days from the date of admission. If, after 30 days, the participant has not returned home, the PCSP/CC Nurse will notify DCO and action will be initiated to close the waiver case.
2. If DCO becomes aware that a participant has been admitted to a nursing facility and it is anticipated that the stay will be short (30 days or less), the waiver case will be closed effective the date of the admission, but the Medicaid case will be left open. When the participant returns home, the waiver case may be reopened effective the date the participant returns home. A new assessment and medical eligibility determination will not be required unless a change of condition is determined requiring a change in SBL.
Nursing facility admissions, when referenced in this section, do not include ARChoices participants admitted to a nursing facility to receive facility-based respite services.
When a waiver participant is absent from the home for reasons other than institutionalization, DCO will not be notified unless the participant does not return home within 30 days. If, after 30 days, the participant has not returned home and the providers can no longer deliver services as authorized on the PCSP (e.g., the participant has left the state and the return date is unknown), the PCSP/CC Nurse will notify DCO. Action will be taken by the DHS Division of County Operations to close the waiver case.
NOTE: It is the responsibility of the provider to notify the PCSP/CC Nurse immediately via form AAS-9511 upon learning of a change in the participant's status.
Credits
Adopted Dec. 27, 2015. Amended Oct. 6, 2016; Jan. 1, 2019; Oct. 1, 2022.
Current with amendments received through May 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.71-212.400, AR ADC 016.06.71-212.400
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