MDS-HC Assessment. The Contractor must complete MDS-HC assessments for its Enrollees as described below. The MDS-HC must be completed in-person by a registered nurse. Information collected on the MDS-HC must be sent to MassHealth via the MDS-HC application in the Commonwealth’s Virtual Gateway to ensure accurate assignment of Rating Categories. The Contractor must cooperate with and participate in any and all requests made by MassHealth for further information concerning any MDS-HC submission. The MDS-HC must be completed as follows:
MDS-HC Assessment. The Contractor must complete MDS‑HC assessments for its Enrollees as described below. The MDS‑HC must be completed in‑person by a registered nurse. Information collected on the MDS‑HC must be sent to MassHealth via the MDS‑HC application in the Commonwealth’s Virtual Gateway to ensure accurate assignment of Rating Categories. The Contractor must cooperate with and participate in any and all requests made by MassHealth for further information concerning any MDS‑HC submission. The MDS‑HC must be completed as follows: For Enrollees assigned to the C1 Rating Category, the MDS‑HC must be completed to change the Rating Category; For Enrollees assigned to the C2 Rating Categories, including C2A and C2B, the MDS‑HC must be completed within 90 days of the Enrollee’s Effective Enrollment Date into One Care, and at least annually thereafter; For Enrollees assigned to the C3 Rating Categories, including C3A and C3B, the MDS‑HC must be completed within 90 days of the Enrollee’s Effective Enrollment Date into One Care and at least annually thereafter; For Enrollees assigned to the C4 Rating Category, the MDS‑HC must be completed: Within thirty (30) days following the Enrollee’s admission into a Transitional Living Program; and Prior to the end of the month of discharge from a Transitional Living Program; In order to change any Enrollee’s Rating Category to a Rating Category, other than the F1 Rating Category based on the Enrollee’s current residence in a long‑term care facility for at least ninety (90) days. Individualized Care Plan The Contractor shall: Engage each Enrollee in ongoing development of their ICP. Ensure that the ICT integrates and coordinates services, including, but not limited to engaging each Enrollee in the development of an ICP. The ICP must: Incorporate the results of the Comprehensive Assessment and specify any changes in providers, services, or medications. Be developed by the ICT under the direction of the Enrollee (and/or the Enrollee’s representative, if applicable), and in consultation with any specialists caring for the Enrollee, in accordance with 42 C.F.R. 438.208(c)(3) and 42 C.F.R. 422.112(a)(6)(iii) and updated periodically to reflect changing needs identified in Comprehensive Assessments. The Enrollee will be at the center of the care planning process. Reflect the Enrollee’s preferences and needs. The Contractor will ensure that the Enrollee receives any necessary assistance and accommodations to prepare for and fully participate in the...
