Library: Policy

317:50-1-10. Medically Fragile Waiver services during hospitalization or NF placement

Issued 8-1-10

     If a member requires hospital or nursing facility services, the case manager assists the member in accessing institutional care, periodically monitors the member's progress during the institutional stay and, as appropriate, updates the service plan and prepares services to start on the date the member is discharged from the institution and returns home. 

• (1) Hospital discharge.  When the member returns home from a hospital or when notified of the member's anticipated discharge date, the case manager notifies relevant providers and coordinates the resumption of services.

• (2) NF placement of less than 30 days.  When the member returns home from a NF stay of 30 days or less or when notified of the member's anticipated discharge date the case manager notifies relevant providers and coordinates the resumption of Medically Fragile Waiver services in the home.

• (3) NF placement greater than 30 days.  When the member is scheduled to be discharged and return home from a SNF stay that is greater than 30 days, the member's case manager expedites the restart of Medically Fragile Waiver services for the member.