Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 22 - DETERMINATION OF NURSING FACILITY LEVEL OF CARE
Section 22-5 - Requests for Determination of Nursing Facility Level of Care

Universal Citation: WY Code of Rules 22-5

Current through September 21, 2024

(a) Any individual may request a nursing facility level of care determination on his or her own behalf.

(b) A guardian or legal representative may request a nursing facility level of care determination on behalf of an individual for whom legal decision-making authority has been conferred.

(c) Employees of a nursing facility, hospital, or any other such healthcare or social services provider may request a nursing facility level of care determination on behalf of any individual for whom that organization has the responsibility for the provision or coordination of healthcare services.

(d) The Department shall approve only those requests for a nursing facility level of care determination which meet all of the following criteria:

(i) The request is complete and is submitted in accordance with the Department's established procedures;

(ii) The individual to be assessed is a resident of, or intends to reside in, the State of Wyoming;

(iii) The individual to be assessed demonstrates a reasonable indication of need for long-term care services as determined by any initial screening criteria established by the Department;

(iv) The individual to be assessed is currently receiving, or has expressed interest in, a long-term care service or program which requires a nursing facility level of care determination; and

(v) The individual to be assessed is a current Wyoming Medicaid recipient, has submitted an application for Wyoming Medicaid, or has been identified by a Preadmission Screening and Resident Review (PASRR) Level I Screening to require a PASRR Level II screening pursuant to Chapter 19.

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