Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part XXI - Home and Community-Based Services Waivers
Subpart 7 - Community Choices Waiver
Chapter 89 - Admission and Discharge Criteria
Section XXI-8903 - Admission Denial or Discharge Criteria
Universal Citation: LA Admin Code XXI-8903
Current through Register Vol. 50, No. 9, September 20, 2024
A. Admission shall be denied or the participant shall be discharged from the Community Choices 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 financial eligibility.
3. The individual does not meet the criteria
for nursing facility level of care.
4. The participant resides in another state
or 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 Community Choices
Waiver services (exclusive of support coordination services) for a period of 30
consecutive days.
EXCEPTION: An exception 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 and welfare of the individual
cannot be reasonably assured through the provision of Community Choices Waiver
services.
7. The individual fails
to cooperate in the eligibility determination or plan of care development
processes or in the performance of the POC.
8. Failure on behalf of the individual to
maintain a safe and legal environment.
9. It is not cost effective or appropriate to
serve the individual in the Community Choices Waiver.
AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.
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