New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 371 - DEVELOPMENTAL DISABILITIES
Part 9 - ADMISSION, DISCHARGE AND TRANSFER OF ELIGIBLE RECIPIENTS FOR SERVICES IN ICF/MR FACILITIES
Section 8.371.9.8 - ADMISSION
Current through Register Vol. 35, No. 18, September 24, 2024
A. No person shall be admitted into an ICF/MR unless the person has been pre-screened and referred to an ICF/MR by the health care authority central registry.
B. Consistent with the provisions of 42 CFR 431.51 any person who requests to be placed on the HCA's central registry will be provided the opportunity to indicate a choice between ICF/MR and home/ community-based waiver services at the time of application to the central registry. The purpose of this information request is for system service planning to identify persons who may be potentially eligible for ICF/MR services.
C. All applicants to the central registry may choose to be placed on the central registry for both ICF/MR and home/community-based waiver services.
D. All persons referred for admission into an ICF/MR from the central registry may choose to remain on the central registry for home/community-based waiver services. All persons referred for admission into home/community-based waiver services may choose to remain on the central registry for ICF/ MR services.
E. All persons applying to the central registry will be pre-screened by the HCA before placement on the central registry to determine each person's choice between ICF/MR and home/ community-based waiver services, and whether the person has a developmental disability or related condition. Pre-screening does not include determination of financial eligibility and level of care, which are functions performed by the state medicaid agency.
F. The HCA will implement application procedures for the central registry that identifies applicant's freedom to choose between ICF/MR and home and community based services.
G. Upon notification from a ICF/MR to the HCA that a vacancy exist in their facility, the HCA will identify three persons from the central registry, in the order of date of application to the central registry, who have indicated a choice for ICF/MR services, and who:
H. The HCA will notify the three persons about the availability of a vacancy and request each person to reaffirm in writing their choice between ICF/MR, developmental disabilities home and community waiver services, or other services.
I. The HCA will furnish to an ICF/MR the names and contact information of any persons on the central registry who indicate a choice for ICF/MR services in the long term services division region in which the ICF/MR is located.
J. The ICF/MR will contact and review each person's request for admission in accordance with federal licensing and certification requirements.
K. The ICF/MR will refer any person referred by the central registry, and whom the ICF/ MR determined appropriate for admission based on its admission decision, to the state medicaid agency for level of care and financial eligibility determination.
L. The ICF/MR will notify the HCA and the eligible central registry person of the results of its admission decision for all three persons referred by the HCA with an explanation for its decision on each person referred. The ICF/MR will notify any person not admitted of their right to a review of the admission decision.
M. The ICF/MR may admit any person who meets the definition of "readmission" without referral through the HCA's central registry. A readmission will not be subject to pre-screening by the HCA.
N. The health care authority central registry may refer an individual to an ICF/MR vacancy based on the HCA's determination that the referral is an emergency. The HCA may exempt an emergency referral from the central registry to be made based on the person's date of application to the central registry.
