Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111

MassHealth
Nursing Facility Bulletin 116
August 1999

TO:      Nursing Facilities Participating in MassHealth

FROM:      Mark E. Reynolds, Acting Commissioner

RE:      Revisions to the Notifications of Clinical Eligibility for Nursing-Facility Services

Introduction                      This bulletin provides you with copies of the newly revised notification forms.  There are two changes to the notification, the length of short-term approval and the PAS/OBRA section.

Background                       All nursing facility notification forms are processed by the aging services access points (ASAPs).  The approval process has been simplified. Approval will be either for up to 90 days or for more than 90 days. The Division initiated this change because it realized that nursing facilities were asked to complete short-term reviews that may have been unnecessary.

The revised notification forms should not affect your discharge planning in any way.  The nursing facility should initiate the discharge process for all short term approvals as soon as the member is admitted.

Nursing Facility                 The nursing facility is responsible for the following activities:
Responsibilities                      ·     completing the Level I PAS/OBRA form on all admissions;
·     beginning the discharge process on the admission of all short-term approvals;
·     completing the Short Term Review on all members who have not been discharged before the 90th day;
·     continuing the discharge process until member is discharged;
·     documenting the discharge process in the member’s medical record; and
·     reporting discharges of all MassHealth members to the ASAP.
(Continue to send the SC-1 to the appropriate MEC upon the discharge of any MassHealth member.)

MassHealth
Nursing Facility Bulletin 116
August 1999
Page 2

Federal                              Although the forms have been revised, the PAS/OBRA process for mental
Requirements                    illness, mental retardation, and developmental disability has not changed. A PAS/OBRA referral is not required if the member is being admitted to the nursing facility to receive care for the same condition for which he or she received hospital care and his or her attending physician certifies before admission to the facility that the individual is expected to require less than 30 days of nursing facility services.

Effective Date                    These procedural changes are effective September 1, 1999.

Questions                         If you have any questions about the information in this bulletin, please contact the Unisys Provider Services Department at (617) 628-4141 or 1-800-325-5231.