Referral and Admission Process a. ODHS has sole and final approval authority over all Contract admissions.
b. All Medicaid admissions under this Contract must be approved by ODHS Central Office prior to admission.
c. Contractor shall screen all Individuals being considered for placement under this Contract and review screening results and all related service planning information with relevant Service Planning Team members, including the ODHS Designee, prior to establishing a targeted admission date.
d. Contractor and the ODHS Designee shall mutually determine the targeted admission date and mutually confirm the actual admission date after receiving confirmation of ODHS Central Office final approval.
e. Contractor shall engage in assessment and planning activities prior to Individual’s placement with Contractor, resulting in sound admission and transition development and coordination. Contractor shall ensure there is documentation supporting the completion of these activities in the Individual’s service record to include all subsequent service plans.
f. Contractor shall coordinate and participate in a minimum of one Transition Planning meeting prior to the targeted admission date with Individual and/or the Individual’s identified support network, both the referring and receiving ODHS Designee and a representative of the provider(s) currently providing services to the Individual (as applicable). The purpose of the Transition Planning meeting is to ensure timely and sound transition planning. Transition Planning participants shall:
(1) Identify ODHS Designee and Contractor transition planning roles and responsibilities;
(2) Identify guardian, representative xxxxx, and designated representative assignments;
(3) Identify primary care physician and other health care provider(s);
(4) Identify Individual’s transition needs to include but not limited to: DME, medications, transportation, supplies, ancillary services, etc.;
(5) Review medical needs with a plan to ensure coordination of medical benefits and services; and
(6) Review existing service or plans and identification of staffing needs.
Referral and Admission Process a. Enhanced Care Coordinator has sole and final approval authority over all contract admissions.
b. All referrals received by the Enhanced Care Coordinator or designee must be screened by Contractor and CMHP, as defined in the Memorandum of Understanding. Contractor and CMHP shall conduct face-to-face screening of referred Individuals within 10 business days of receiving the referral
Referral and Admission Process a. ODHS has sole and final approval authority over all Contract admissions.
b. All Medicaid admissions under this Contract must be approved by ODHS Central Office prior to admission.
c. Contractor shall screen all Individuals being considered for placement under this Contract and review screening results and all related service planning information with relevant Service Planning Team members, including the ODHS Designee, prior to establishing a targeted admission date.
Referral and Admission Process a. Contract Administrator has sole and final approval authority over all Contract admissions.
b. Contractor and CMHP shall jointly screen all referrals in a manner defined in the Memorandum of Understanding. Screenings shall occur within 10 business days of receiving the referral packet.
c. Contractor and CMHP shall jointly review the screening results and all service planning information, coming to a mutual decision within 21 business days of initial referral.
d. Contractor and CMHP shall jointly submit a written screening outcome to the Contract Administrator. Such written documentation shall indicate acceptance or denial with specific barriers detailed.
e. The Contractor and the ODHS Designee shall mutually determine the targeted admission date and notify the Contract Administrator.
f. Contractor shall engage in assessment and planning activities prior to Individual’s admission, resulting in sound admission and transition development and coordination. Contractor shall ensure there is documentation supporting the completion of these activities in the Individual’s service record.
g. In the event that Contractor and CMHP cannot come to a mutual decision regarding acceptance or denial, methods of deliberation shall be outlined in the Memorandum of Understanding and Contract Administrator notified.
h. Multiple rejections of referrals or failure to complete timely screenings will be reviewed by Contract Administrator and may be taken into consideration during Contract renewal process.
i. Contractor agrees to reserve 16 beds for consumers eligible for Medicaid Long- Term Care Services pursuant to Oregon Administrative Rules Chapter 411, Division 015 rules. The Contract Administrator must approve admission for Individuals eligible for services under other programs or for private pay Individuals. This decision is at the discretion of ODHS and the contract administrator. Approval for admission of Individuals not eligible for Medicaid Long-Term care will not obligate ODHS to fund these admissions.
Referral and Admission Process a. ODHS shall have no financial responsibility until Individual's eligibility has been approved, the placement and payment have been authorized by ODHS and the Transition Planning Meeting has occurred. The Service payment shall become effective on the date of placement pursuant to a fully executed Contract.
b. ODHS has sole and final approval authority over all Contract admissions.
c. All Medicaid admissions under this Contract must be approved by ODHS prior to admission.
d. Contractor shall screen all Individuals being considered for placement under this Contract and review screening results and all related service planning information with relevant Service Planning Team members, including the ODHS Designee, prior to establishing a targeted admission date.
e. Contractor and the ODHS Designee shall mutually determine the targeted admission date and mutually confirm the actual admission date after receiving confirmation of ODHS final approval.
f. Contractor shall engage in assessment and planning activities prior to Individual's placement with Contractor, resulting in sound admission and transition development and coordination. Contractor shall ensure there is documentation supporting the completion of these activities in the Individual's service record to include all subsequent Service Plans.
g. Contractor shall coordinate and participate in a minimum of one Transition Planning meeting prior to the targeted admission date with Individual and/or the Individual's identified support network, both the referring and receiving ODHS Designee and a representative of the provider(s) currently providing Services to the Individual (as applicable). Transition Planning participants shall:
(1) Identify ODHS Designee and Contractor Transition Planning roles and responsibilities;
(2) Identify guardian, representative xxxxx, and designated representative assignments;
(3) Identify primary care physician and other health care provider(s);
(4) Identify Individual's transition needs to include but not limited to: DME, medications, transportation, supplies, ancillary services, etc.;
(5) Review medical needs with a plan to ensure coordination of medical benefits and services; and
(6) Review existing Services or plans and identification of staffing needs.
Referral and Admission Process a. ODHS has sole and final approval authority over all Contract admissions.
b. All Medicaid admissions under this Contract must be approved by ODHS prior to admission.
c. Contractor will reserve 15 beds for consumers eligible for Medicaid Long-Term Care Services pursuant to Oregon Administrative Rules Chapter 411 Division 015 rules. The Contract Administrator approve admission for individuals eligible for services under other programs or for private pay individuals. This decision is at the discretion of ODHS and the contract administrator and will not obligate ODHS to fund these admissions.
d. Contractor will screen all Individuals being considered for placement under this Contract and review screening results and all related service planning information with relevant Service Planning Team members, including the ODHS Designee, prior to establishing a targeted admission date.
e. admission, resulting in sound admission and transition development and coordination. Contractor shall ensure there is documentation supporting the completion of these activ subsequent Service Plans.
f. Contractor shall coordinate and participate in a minimum of one Transition Planning meeting prior to the targeted admission date with Individual and/or the
(1) around Transition Planning;
(2) Identify guardian, representative xxxxx, and designated representative assignments;
(3) Identify primary care physician and other health care provider(s);
(4) medications, transportation, supplies, ancillary services, etc;
(5) Review medical needs with a plan to ensure coordination of medical benefits and services; and
(6) Review existing Services or plans and identification of staffing needs.
Referral and Admission Process a. ODHS has sole and final approval authority over all Contract admissions.
b. All Medicaid admissions under this Contract must be approved by ODHS prior to admission.
c. Contractor will screen all Individuals being considered for placement under this Contract and review screening results and all related service planning information with relevant Service Planning Team members, including the ODHS Designee, prior to establishing a targeted admission date.
d. Contractor and the ODHS Designee will mutually determine the targeted admission date and mutually confirm the actual admission date after receiving confirmation of ODHS final approval.
e. Contractor will engage in assessment and planning activities prior to Individual’s placement with Contractor, resulting in sound admission and transition development and coordination. Contractor will ensure there is documentation supporting the
f. Contractor will coordinate and participate in a minimum of one Transition Planning meeting prior to the targeted admission date with Individual and/or the Individual’s identified support network, both the referring and receiving ODHS Designee and a representative of the provider(s) currently providing Services to the Individual (as applicable). Transition Planning participants will:
(1) Identify ODHS Designee and Contractor Transition Planning roles and responsibilities;
(2) Identify guardian, representative xxxxx, and designated representative assignments;
(3) Identify primary care physician and other health care provider(s);
(4) Identify Individual’s transition needs to include but not limited to: DME, medications, transportation, supplies, ancillary services, etc;
(5) Review medical needs with a plan to ensure coordination of medical benefits and services; and
(6) Review existing Services or plans and identification of staffing needs.
Referral and Admission Process a. Contract Administrator has sole and final approval authority over all contract admissions.
b. All referrals received by the Contract Administrator or designee must be screened by Contractor and CMHP, as defined in the Memorandum of Understanding. Contractor and CMHP shall screen all Individuals being considered for placement under this Contract within 10 business days of receiving the referral packet.
c. Contractor and CMHP shall mutually decide to accept or refuse the referral within 21 business days of packet receipt, based on review of screening results and all related care planning information with relevant IDT members.
d. Contractor shall provide written documentation to Contract Administrator, describing specific clinical barriers to the admission and identify the Services that would need to be added to address these barriers, in the event that Contractor and the CMHP decide not to accept a referral.
e. Contractor and the ODHS Designee shall mutually determine the targeted admission date, mutually confirm the actual admission date and notify the Contract Administrator.
f. Opposing admission decisions between Contractor and CMHP must be addressed per the Memorandum of Understanding and reported by Contractor to Contract Administrator.
g. Multiple rejections of referrals or failure to complete timely screenings will be reviewed by Contract Administrator and may be taken into consideration during Contract renewal process.
h. The initial Care Plan must incorporate the Individual’s discharge goals and outline strategies to achieve those goals.
