Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part XXI - Home and Community-Based Services Waivers
Subpart 3 - Adult Day Health Care Waiver
Chapter 25 - Admission and Discharge Criteria
Section XXI-2503 - Admission Denial or Discharge Criteria
Universal Citation: LA Admin Code XXI-2503
Current through Register Vol. 50, No. 9, September 20, 2024
A. Admission shall be denied or the participant shall be discharged from the ADHC Waiver Program if any of the following conditions are determined.
1. The
individual does not meet the target population criteria as specified in the
federally approved waiver document.
2. The individual does not meet the criteria
for Medicaid eligibility.
3. The
individual does not meet the criteria for nursing facility level of
care.
4. The individual resides in
another state or the participant has a change of residence to another
state.
5. Continuity of services is
interrupted as a result of the participant not receiving and/or refusing ADHC
waiver services (exclusive of support coordination services) for a period of 30
consecutive days.
a. Exceptions may be
granted by OAAS to delay discharge if interruption is due to an acute care
hospital, rehabilitation hospital, or nursing facility
admission.
6. The health,
safety and welfare of the individual cannot be assured through the provision of
ADHC waiver services.
7. The
individual/participant fails to cooperate in the eligibility determination
process, POC development, or in the performance of the POC.
8. It is not cost effective or appropriate to
serve the individual in the ADHC Waiver.
9. The participant fails to attend the ADHC
center for a minimum of 36 days per calendar quarter.
10. The participant fails to maintain a safe
and legal home environment.
AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and pursuant to Title XIX of the Social Security Act.
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