Is there a break in coverage when a resident moves from short-term care to long-term care? If yes, will the segment be opened back to its original segment?
As indicated in Eligibility Operations Memo 09-09, if the six-month short-term period expires and the member is still a patient at the nursing facility or is no longer on a short-term stay, the following will take place. The payment segment will be closed by the Short-Term-Care Processing Unit worker. The Short-Term-Care Processing Unit will send an Expiration of Short-Term Stay and Home Maintenance Needs Allowance (ST-CL) cover letter and a Supplement A detailing the need for the supplement to be completed by the nursing facility on behalf of the member. (If the member is under the age of 65, a MER/TRANS form will also be sent to the nursing facility.) The completed forms must be returned to the appropriate MEC with an SC-1 form, stating that the member is transitioning from a short-term stay to a stay of more than six months. A new level-of-care determination form is notneeded. If all required documentation is received, the segment will be coded with the original date.
Related Questions
- Who says a long-term position is boring? Usually one will have many short-term moves against the direction of the long-term position, so why let them go waste?
- When considering purchasing either long-term disability or short-term disability coverage, which one is better?
- How do I receive benefits under my Long-Term Care, Short-Term Care, Facility Care, or Home Health Care coverage?
