AGING AND DISABILITY SERVICES ADMINISTRATION

November 7, 2003

ADSA: BH #2003-023
REASSESSMENT/ SIGNIFICANT CHANGE

Dear Boarding Home Provider:

You are receiving this letter as notification that the Aging and Disability Services Administration (ADSA) is changing the Home and Community Services (HCS) assessment requirements for existing Medicaid clients who leave a Boarding Home (BH) for treatment in a hospital setting and then return directly to a BH. The licensing requirements related to resident assessments found at Revised Code of Washington (RCW) 70.129.030 (3) and Washington Administrative Code (WAC) 388-78A-260(1)(b) remain unchanged.

When a Medicaid client returns from a stay in a hospital, an HCS reassessment is only required when the BH believes there is a significant change in the returning resident.

•  A significant change is defined as a change in a resident's health status or physical, emotional or mental functioning (an improvement or decline) that requires the intervention of a physician, a physician assistant as defined in WAC 246-918-055, or an advanced registered nurse practitioner as defined in WAC 246-840-299.

The BH may then request an assessment by the Home and Community Services or Division of Developmental Disabilities Social Worker assigned to the BH. That assessment will be completed and the service/care plan revised, if necessary, and authorized for the client.

If you believe the returning Medicaid resident has had a significant change please contact the Social Worker assigned to your facility and request an assessment. Please remember that this change in HCS procedure does not reflect a change in the licensing requirements related to resident assessment.

If you have any questions on this change in procedure, please contact George Zimmerman, Residential Policy Manager, at (360) 725-2534 or zimmegm@dshs.wa.gov .

Sincerely,

Patricia K. Lashway, Director
Residential Care Services