Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 240 - COMMUNITY CARE PROGRAM
Subpart J - SPECIAL SERVICES
Section 240.1010 - Choices for Care Nursing Facility, Supportive Living Program, and Community-Based Screening
Current through Register Vol. 48, No. 12, March 22, 2024
a) Choices for Care nursing facility, supportive living program, and community-based prescreening is the assessment of the need of all participants age 60 and over, regardless of the payment source, prior to placement in a nursing facility (licensed under the Nursing Home Care Act; certified to participate in the Medicare program under Title XVIII of the Social Security Act ( 42 USC 301 et seq.), or certified to participate in the Medicaid program under Title XIX of the Social Security Act; placement in a supportive living program (Medicaid waiver)); or to determine if the participant/authorized representative chooses community-based services and supports.
b) Except as indicated in subsections (j) and (l), any participant seeking admission to a nursing facility or supportive living program must be screened to determine his/her need for nursing facility or supportive living program services pursuant to this Section.
c) Prescreening shall be accomplished by completion of the DON, completion of the HFS Interagency Certification of Screening Results form, and completion of an HFS OBRA Level I Screen if the participant is determined appropriate for nursing facility or supportive living program placement. In addition, the participant will receive a copy of:
d)In compliance with federal Preadmission Screening and Resident Review (PASRR) requirements, when CCUs completing the HFS OBRA Level I Screen determine there is a suspicion of and a reasonable basis to suspect mental illness and/or developmental disability, the CCU shall make the appropriate referral to contracted providers of DHS-Division of Mental Health or DHS-Division of Developmental Disabilities within 1 day to determine if an HFS OBRA Level II Screen is required. If it is determined that no further screening is required by the DHS contracted providers, the CCU shall complete the required forms. If further screening is required by the DHS contracted providers, that entity shall complete the required forms.
e)The hospital shall notify the CCU at least 24 hours prior to discharge.
f) CCUs will have the capacity to complete face-to-face prescreenings 7 days per week, at a minimum of 7 hours per day. CCUs are not required to complete screens on federal holidays.
g) Responsibility for prescreenings shall be vested in the CCUs. The CCU is responsible for ensuring that copies of the HFS Interagency Certification of Screening Results form and the HFS OBRA Level I Screen are sent to the appropriate nursing facility or supportive living program.
h) The participant who is prescreened shall:
i) Postscreening shall occur if a participant is admitted to a nursing facility or supportive living program without benefit of prescreening.
j) Nursing facility prescreening does not apply to the following:
k)A prescreening or postscreening for supportive living program admissions is not required for:
l) Any participant who has been admitted to a nursing facility that operates under the Hospital Licensing Act [ 210 ILCS 85 ], or provider licensed under Section 35 of the Alternative Health Care Delivery Act [ 210 ILCS 3/35 ], whose actual length of stay in the facility exceeds 21 calendar days, shall be screened to determine the participant's need for continued services.
m) Nursing facility conversion screening is the assessment of the appropriateness of in-home and community-based care for nursing facility residents age 60 and over who have applied for and been found eligible for Medicaid assistance.