AAU Provider Update: ADvantage to Nursing Facility to ADvantage Proces

A new process has been designed to assist OKDHS in expediting processes when an ADvantage member enters the Nursing Facility and is able to return to their residence, with ADvantage services, within a 90 day timeframe.

Users are urged to call 1-800-435-4711 to report that an ADvantage member has entered the Nursing Facility or is preparing to discharge from the Nursing Facility. This will assist in allowing OKDHS to make the transition as seamless as possible.

You will need to provide the following information:

• First and last name of member
• Home address or address of residence to which member will be discharged
• Discharge date from Nursing Facility
• Telephone number at which member may be reached.

Persons who should utilize this process are:

• ADvantage Members and their Families-As soon as a member or their families know that the member is going to enter the Nursing Facility or discharge from the Nursing Facility, they should use this process to advise OKDHS.
• Case Managers-This process is to be provided and explained to the member and family at the initial IDT meeting. It is also to be discussed with the member and family during home visits thereafter. It is to be utilized (in place of an ADv9) whenever the Case Manager becomes aware that the member is planning on going into the Nursing Facility or discharging from the Nursing Facility.
• Provider Agencies-This process is to be utilized whenever the agency becomes aware that the member is planning on going into the Nursing Facility or discharging from the Nursing Facility. Because the PCA is in daily contact with the member and the skilled nurse may know of the Member’s emerging health issues, the provider agency may be the first person to know of this information and should follow this process as quickly as possible.
• OKDHS Long Term Care Nurses-This document will be given and explained to the applicant and family during the initial UCAT.
• Hospital Discharge Planners-This process is to be utilized when the hospital discharge planner becomes aware that a member may be going to a Nursing Facility from the hospital.
• Nursing Facilities-This process is to be utilized when the Nursing Facility is aware that an ADvantage member has checked into their facility or is planning on discharging from their facility.

If you have any questions or concerns regarding the information provided above, please feel free to contact us via email at Provider Questions.