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.

• Level of Care Determination (LOC)It is the responsibility of the County to initiate the screening either by telephoning Dual Diagnosis Management (DDM) or by submitting information to DDM (the web based method is the preferred method to submit information to DDM).

• Nursing Facility (HCBS) Level of Care Determination But The Client Is Not Receiving Waivered ServicesThe stop date on the screening is important for Medicaid recipients having a spouse in the household.

• 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).

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 services, nursing facility services, or ICF/IID

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 an assessment and evaluation by ODJFS or its designee of an individual's physical, mental, social, and emotional status, using the processes described in rules 5101:3-3-15, 5101:3-3-15.3, and 5101:3-3- 15.5 of the Administrative Code, to compare the criteria for all of the possible levels of care as described in rules 5101:3-3-06 to 5101:3-3-08 of the Administrative Code, and make a decision about whether an individual meets the criteria for a level of care.

Level of Care Determination means the application of the results of the assessment to ascertain whether there is a reasonable indication that individuals might need ICF/MR services in the near future but for the availability of home and community-based services.

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. ¶