FOUR things to keep in mind regarding ALTCS medical eligibility (PAS – Pre-Admission Screening)
The eligibility is getting tougher. For example, it used to be that a dementia diagnosis in the chart was sufficient. Now, it must be documented by a neurologist. If you have a potential ALTCS applicant with dementia or Alzheimer’s disease, make sure you encourage them to schedule and follow through on their visit to a neurologist. This is worth 20 of the 60 points needed to qualify!
ALTCS really only needs the following records: the most recent history and physical, physician progress notes for a year, documented list of medical conditions and diagnoses, prescription and OTC list, hospital and/or SNF discharge summaries from the past 6 months, and if residing in assisted living, the most recent monthly or quarterly needs assessment.
Remember to request records in advance to prevent delays in processing. These can be provided to ALTCS before the actual medical assessment.
If you or other family members are providing care to the ALTCS applicant, begin journaling the services you are providing (date of service, time started, time ended, what service was performed). This will help show ALTCS how often the care is needed. It also helps to put things in terms the ALTCS PAS assessor understands. Use the activities of daily living (ADL) terminology: bathing, dressing, grooming, toileting, mobility, transferring, eating AND whether the ALTCS applicant needs prompting, some hands-on assistance, or full hands-on assistance with each of those areas.
Need a Caregiver Agreement, or an impartial PAS evaluation before you apply? We can help. Montgomery & Associates employs consultants and a certified legal document preparer to help you successfully navigate the ALTCS process the first time you apply.
Give us a call today! 480-464-4968
