Level of Care Determination definition

Level of Care Determination means an evaluation of the intensity of a person’s health service needs. The level of care determination may not be used to require that the person receive services in a nursing facility.

Level of Care Determination means the standardized process implemented to establish the type, frequency, and duration of medically appropriate services required to treat a diagnosed behavioral health condition.

Level of Care Determination means a determination of whether an individual needs the level of care provided by a hospital, nursing facility, or ICF/IID and whether the individual, if determined to need that level of care, would receive hospital services, nursing facility services, or ICF/IID services if not for a home and community-based services medicaid waiver component.

Examples of Level of Care Determination in a sentence

• Michigan’s Nursing Facility Level of Care Determination (NFLOCD) tool will be used to determine in which Tier an enrollee will be placed.

• The Michigan Medicaid Nursing Facility Level of Care Determination must be completed by a health care professional.

• ICOs will also be required to complete the Nursing Facility Level of Care Determination (NFLOCD) tool and submit to CHAMPS for final approval of whether the individual meets nursing facility level of care (NFLOC).No. Contracted entities do not perform waiver operational and administrative functions on behalf of the Medicaid agency and/or the operating agency (if applicable).

• All applicants for MI Choice must meet nursing facility level of care requirements as determined by a qualified professional through an evaluation using the Michigan Medicaid Nursing Facility Level of Care Determination (LOCD).

• The Michigan Medicaid Nursing Facility Level of Care Determination must be completed by a health care professional: physician, registered nurse, licensed practical nurse, licensed social worker (BSW or MSW), a physician assistant, physical therapist, occupational therapist, or speech therapist.

More Definitions of Level of Care Determination

Level of Care Determination means a determination by the department that an individ- ual meets patient status criteria for an intermediate care facility for individuals with intellectual disabilities as established in 907 KAR 1:022.

Level of Care Determination means an assessment of a person and the resulting determination

Level of Care Determination means a determination of whether an individual needs the level of care provided by a hospital, nursing facility, or ICF/IID and whether the individual, if determined to need that level of care, would receive hospital

Level of Care Determination means documentation in the service record that justifies the change in a Level of Care placement, whether the placement is more intensive or less intensive, completed in a 6-Dimensional format that captures what has changed for the individual and resulted in the change in placement. The Level of Care Determination shall include the assessed level of care, the placed level of care, the individual's preferred level of care, and a rationale if there is a difference between the assessed and placed levels of care. ¶

Level of Care Determination means a decision by the department of an individual's physical, mental, social, and emotional status using the processes described in this rule, to compare the criteria for all possible levels of care as described in this rule and rules 5160-3-06, 5160-3-08, and 5160-3-09 of the Administrative Code about whether an individual meets the criteria for level of care. A level of care determination shall be valid for up to twelve months unless the individual has experienced a significant change of condition.

Level of Care Determination means a determination by the department that an individ- ual meets patient status criteria for an intermediate care facility for an individual with an intel- lectual disability as established in 907 KAR 1:022.

Level of Care Determination means a determination of 47