Frequently Asked Questions are used to provide additional information and/or statutory guidance not found in State Medicaid Director Letters, State Health Official Letters, or CMCS Informational Bulletins. The different sets of FAQs as originally released can be accessed below.
Frequently Asked Questions
No, discharges that result in readmission to the institution within 60 days of discharge from the institution do not meet the LTSS Minimizing Institutional Length of Stay and LTSS Successful Transition after Long-Term Institutional Stay measure numerator criteria.
Do not count the day of discharge unless the member’s admission and discharge occurred on the same day. If the admission and discharge occurred on the same day, the number of days in the stay is equal to one.
If there is no discharge, calculate the length of stay as the date of the last day of the measurement year minus the institutional facility admission date.
Yes, the LTSS Minimizing Institutional Length of Stay and LTSS Successful Transition after Long- Term Institutional Stay measures are risk-adjusted based on the members’ dual eligibility status, age and gender, diagnoses from the institutional facility admission, and number of hospital stays and months of enrollment in the classification period. See the risk adjustment weights needed for these measures are in the risk adjustment tables.
No, do not include these admissions in the LTSS Successful Transition after Long-Term Institutional Stay measure denominator.
No, these would be two distinct institutional stays; do not remove this admission from the Long Term Services and Supports Successful Transition after Long-Term Institutional Stay measure denominator.
If the member died in the institution or within one day of discharge from the institution, do not include their admission in the denominator. Members who died one day after discharge are excluded because of the high number of deaths the day after discharge observed while testing this measure; such members are unlikely to have been discharged alive. If the member died between day 2 and day 60 during the 60 days following discharge from the long-term institutional stay, do not include their discharge in the numerator.
No. Although a comprehensive assessment may include falls risk assessment elements, this measure does not require the risk assessment elements to be documented as part of a comprehensive assessment. For this measure, a falls risk assessment is considered complete if the member record includes any documentation of a balance/gait assessment, and documentation of assessment of postural blood pressure, vision, home fall hazards, and/or medications.
Date: March 1, 2019
Topics:
Managed Long Term Services and Supports (MLTSS)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls
Subtopics:
Falls Part 2 (Risk Assessment and Plan of Care)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls: Falls Part 2 (Risk Assessment and Plan of Care)
No, the components can be completed during separate encounters, provided they are documented in the member record as having been performed between August 1 of the year prior to the measurement year and December 31 of the measurement year.
Date: March 1, 2019
Topics:
Managed Long Term Services and Supports (MLTSS)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls
Subtopics:
Falls Part 2 (Risk Assessment and Plan of Care)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls: Falls Part 2 (Risk Assessment and Plan of Care)
No, a standardized tool is not required, although documentation of use of a standardized tool (for example, Get Up & Go, Berg, Tinetti) would meet the balance/gait assessment component of the measure.
Date: March 1, 2019
Topics:
Managed Long Term Services and Supports (MLTSS)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls
Subtopics:
Falls Part 2 (Risk Assessment and Plan of Care)
Screening, Risk Assessment, and Plan of Care to Prevent Future Falls: Falls Part 2 (Risk Assessment and Plan of Care)