Common use of Intake Clause in Contracts

Intake. Intake begins when you or someone calls on your behalf or comes to LIFE. • If it appears from this conversation that you are potentially eligible, a LIFE Enrollment Specialist will schedule a visit to your home, explain our program and conduct a preliminary screening. • We will ask that you sign a release of information allowing us to obtain your past medical records so our Interdisciplinary Team can fully assess your health status. • Gathering this information will allow you to attend the LIFE center so that you can get to know us and have your health needs evaluated by each Interdisciplinary Team Member. A tuberculosis skin test(s) or a chest x-ray, or proof of within the last year is required during the enrollment/ intake process. Testing will be done at intake if needed and results will not impact or preclude enrollment. • LIFE is committed to serving the elderly who need long-term care; therefore, an independent opinion must confirm that your health status qualifies you to join the PACE program administered by LIFE St. Xxxxxx of the Pines. • Our LIFE Staff will complete the information on the North Carolina Medicaid Program Long Term Care Services Assessment tool and will submit to the Division of Medical Assistance. • The Division of Medical Assistance will review this Assessment tool submitted by LIFE and determine if you are eligible for nursing home care by state requirements. In the event that the Division of Medical Assistance finds that you are not eligible for nursing home care by state requirements, you will not be able to enroll into the program. If we determine you are not able to live safely in the community, your enrollment will be denied. LIFE will work with you to make other arrangements for the care you need. You have the right to appeal your eligibility determination or a denial of enrollment. This appeal should be made through the State Fair Hearing Process through the Office of Administrative Hearings: If you are a Medicare Beneficiary or Private Pay for the LIFE program you can contact: • Should the Division of Medical Assistance approve that you are eligible for nursing home care by state requirements, assessments will occur in the LIFE Center and in your home. • First, the In-Home Services Coordinator, RN, a member of the Interdisciplinary Team, will coordinate a time to visit you in your home and determine if you can live safely in the community with LIFE services. There may be other members of the Interdisciplinary Team who may also visit you in your home. • Next, the Interdisciplinary Team and an Enrollment Specialist coordinate a time for you to come to the LIFE Center. Here, various Interdisciplinary Team members shall evaluate your needs. • When each Interdisciplinary Team member has evaluated your situation, the Interdisciplinary Team will meet to share their findings and will develop your individual plan of care.

Intake. Intake The intake process begins when you or someone calls on your behalf or comes to LIFEcontacts CHA PACE. • If it appears from this conversation that you are potentially eligible, a LIFE Enrollment Specialist A representative will schedule a visit to your home, explain our program and conduct a preliminary screeningobtain further information about you. • We How CHA PACE works • The kinds of services CHA PACE offers • The answers to any questions you may have about CHA PACE • That when you enroll, you must agree to receive all your medical and health care exclusively from CHA PACE or its contracted service providers, with the exception of emergency services • Your monthly payment, if any If you are interested in joining CHA PACE, the CHA PACE enrollment staff will discuss your health and safety status with other members of the enrollment team. CHA PACE will ask that you sign a release of information allowing us to obtain your past medical records so our Interdisciplinary Team can fully assess team has complete information about your health conditions. Within three weeks, we will have evaluated your health and safety status. • Gathering We will meet to share our findings and ideas for your care. At this information meeting, we will allow decide whether you to attend meet the LIFE center so criteria for admission into the program, that you can get to know us and have is, whether your health needs evaluated by each Interdisciplinary Team Member. A tuberculosis skin test(s) or a chest xappear to meet the MassHealth criteria for nursing facility level-ray, or proof of within the last year is required during the enrollment/ intake process. Testing will be done at intake if needed of-care and results will not impact or preclude enrollment. • LIFE is committed to serving the elderly who need long-term care; therefore, an independent opinion must confirm that your health status qualifies you to join the PACE program administered by LIFE St. Xxxxxx of the Pines. • Our LIFE Staff will complete the information on the North Carolina Medicaid Program Long Term Care Services Assessment tool and will submit to the Division of Medical Assistance. • The Division of Medical Assistance will review this Assessment tool submitted by LIFE and determine if whether you are eligible for nursing living safely in your home care by state requirements. In the event that the Division of Medical Assistance finds that you are not eligible for nursing home care by state requirements, you will not be able to enroll into the program. If we determine you are not able to live safely or in the community. This includes assessing whether CHA PACE can meet your medical, nursing, psychological and social needs in conjunction with your family or support network, if any, and whether remaining in your home or in the community jeopardizes your health and safety. You may be denied enrollment if remaining in your home and or the community would jeopardize your health and safety. In such cases, the CHA PACE staff will be denied. LIFE will work with provide written notification explaining the reason for the denial and refer you to make other arrangements for the care you needappropriate alternative services. You have the right to appeal your eligibility determination or a denial of enrollment. This appeal should be made through the State Fair Hearing Process through the Mailing Address: Executive Office of Administrative HearingsHealth & Human Services Board of Hearings Location: 000 Xxxxxxx Xx. Quincy, MA 02171 Phone: (000) 000-0000 Or 0-000-000-0000 TTY: (000) 000-0000 Fax: (000) 000-0000 If you are a Medicare Beneficiary or Private Pay for the LIFE program you can contact: • Should the Division of Medical Assistance approve we assess that you are eligible for nursing home CHA PACE, you and your care giver/family will be invited to meet with our staff. At that time, we will review and come to an agreement about your participation in CHA PACE before you sign the Enrollment Agreement. At this meeting you and your care giver/family will have an opportunity to: • Discuss the plan of care recommended by state requirements, assessments will occur in the LIFE Center enrollment staff and in your homesuggestions and preferences. • FirstAsk questions about your monthly payment, if any. • Ask questions about losing Medicare and MassHealth benefits that you may currently have (except for emergency or urgent care), as you will only be eligible for services provided and/or authorized by CHA PACE after enrollment. • Discuss the In-Home Services Coordinatorpartnership between you, RN, a member of the Interdisciplinary Team, will coordinate a time and/or your caregiver/family and CHA PACE. • What to visit you in your home and determine do if you can live safely in are dissatisfied with the community with LIFE services. There may be other members care you receive from CHA PACE (see the Grievances and Appeals section of the Interdisciplinary Team who may also visit you in your homethis agreement). • NextIf you decide to join CHA PACE, you will be given the Interdisciplinary Team opportunity to agree to and an accept the conditions of enrollment by signing the Enrollment Specialist coordinate a time for you to come to the LIFE Center. Here, various Interdisciplinary Team members shall evaluate your needs. • When each Interdisciplinary Team member has evaluated your situation, the Interdisciplinary Team will meet to share their findings and will develop your individual plan of careAgreement.

Intake. Intake The intake process begins when you or someone calls on your behalf or comes to LIFEcontacts ESP. • If it appears from this conversation that you are potentially eligible, a LIFE Enrollment Specialist A representative will schedule a visit to your home, explain our program and conduct a preliminary screeningobtain further information about you. • We How ESP works • The kinds of services ESP offers • The answers to any questions you may have about ESP • That when you enroll, you must agree to receive all your medical and health care exclusively from ESP or its contracted service providers, with the exception of emergency services • Your monthly payment, if any If you are interested in joining ESP, ESP’s enrollment staff will discuss your health and safety status with other members of the enrollment team. ESP will ask that you sign a release of information allowing us to obtain your past medical records so our Interdisciplinary Team can fully assess team has complete information about your health conditions. Within three weeks, we will have evaluated your health and safety status. • Gathering We will meet to share our findings and ideas for your care. At this information meeting, we will allow decide whether you to attend meet the LIFE center so criteria for admission into the program, that you can get to know us and have is, whether your health needs evaluated by each Interdisciplinary Team Memberappear to meet the MassHealth criteria for nursing facility level-of-care and whether you are living safely in your home or in the community. A tuberculosis skin test(sThis includes assessing whether ESP can meet your medical, nursing, psychological and social needs in conjunction with your family or support network, if any, and whether remaining in your home or in the community jeopardizes your health and safety. You may be denied enrollment if remaining in your home and or the community would jeopardize your health and safety. In such cases, ESP staff will provide written notification explaining the reason for the denial and refer you to appropriate alternative services. Mailing Address: Executive Office of Health & Human Services Board of Hearings Location: 000 Xxxxxxx Xx. Quincy, MA 02171 Phone: (000) or a chest x000-ray0000 Or 0-000-000-0000 TTY: (000) 000-0000 Fax: (000) 000-0000 If we assess that you are eligible for ESP, or proof of within the last year is required during the enrollment/ intake process. Testing you and your care giver/family will be done at intake invited to meet with our staff. At that time, we will review and come to an agreement about your participation in ESP before you sign the Enrollment Agreement. At this meeting you and your care giver/family will have an opportunity to: • Discuss the plan of care recommended by enrollment staff and your suggestions and preferences. • Ask questions about your monthly payment, if needed any. • Ask questions about losing Medicare and results MassHealth benefits that you may currently have (except for emergency or urgent care), as you will not impact or preclude only be eligible for services provided and/or authorized by ESP after enrollment. • LIFE Discuss the partnership between you, and/or your caregiver/family and ESP. • What to do if you are dissatisfied with the care you receive from ESP (see the Grievances and Appeals section of this agreement). • If you decide to join ESP, you will be given the opportunity to agree to and accept the conditions of enrollment by signing the Enrollment Agreement. ESP is committed authorized to serving the elderly who need long-term serve only those eligible for a nursing facility level of care; therefore. Accordingly, an independent opinion outside screening must confirm that your health status situation in fact qualifies you to join for this care. At the PACE program administered by LIFE St. Xxxxxx time of enrollment, MassHealth, through its screening agent, authorizes your eligibility for ESP. If the Pines. • Our LIFE Staff will complete the information on the North Carolina Medicaid Program Long Term Care Services Assessment tool and will submit to the Division of Medical Assistance. • The Division of Medical Assistance will review this Assessment tool submitted by LIFE and determine if you are eligible for nursing home care by state requirements. In the event that the Division of Medical Assistance screening agent finds that you are not eligible qualified for a nursing home care by state requirementsfacility level of care, you will not be able eligible to enroll into enroll, though you would have the programright to appeal this finding. If we On an annual basis, the screening agent of the MassHealth program will determine whether you are not able continue to live safely be eligible for a nursing facility level of care. If, in the communityopinion of the screening agent, your enrollment you do not meet the criteria for long term care, you will be denieddeemed ineligible for ESP, and you must disenroll. LIFE ESP’s staff will work with you to make other arrangements for the care you need. You have the right to appeal your eligibility determination or a denial of enrollment. This appeal should be made through the State Fair Hearing Process through the Office of Administrative Hearings: If reinstate you, if you are a Medicare Beneficiary or Private Pay for the LIFE program you can contact: • Should the Division of Medical Assistance approve that you are eligible for nursing home care by state requirements, assessments will occur in the LIFE Center and in your home. • First, the In-Home Services Coordinator, RN, a member of the Interdisciplinary Team, will coordinate a time to visit you in your home and determine if you can live safely in the community with LIFE services. There may be other members of the Interdisciplinary Team who may also visit you in your home. • Next, the Interdisciplinary Team and an Enrollment Specialist coordinate a time for you to come to the LIFE Center. Here, various Interdisciplinary Team members shall evaluate your needs. • When each Interdisciplinary Team member has evaluated your situation, the Interdisciplinary Team will meet to share their findings and will develop your individual plan of careeligible.