Level of Care Determinations. for Members who are expected to always meet Nursing Facility Level of Care. 4.1.3.1 If the CONTRACTOR determines that the Member meets ongoing nursing facility level of care based on criteria prescribed by HSD and outlined in the Managed Care Policy Manual, the CONTRACTOR shall approve an ongoing NF LOC for the Member and will not annually assess the Member for NF LOC. 4.1.3.2 The CONTRACTOR is required to perform a CNA and develop an annual care plan for these Members as described in Sections 4.4.5 and 4.4.9. 4.1.3.3 The CONTRACTOR shall monitor the ongoing NF LOC status of Members, and report to HSD as required.
Appears in 14 contracts
Samples: Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement
