§ 71-5-1405. Single Entry Point Into the Long-Term Care System
The commissioner shall ensure that there is a single entry point into the long-term care system that is responsible for ensuring that persons seeking care and their families have access to readily available, easy-to-understand information about long-term care options. Functions performed by the single entry point may include counseling and assistance in evaluating long-term care […]
§ 71-5-1406. Implementation of Policies and Processes by Commissioner
The commissioner shall implement policies and processes that expedite the determination of medicaid categorical and financial eligibility and medical eligibility for home and community-based programs and services, either through contracted functions of the department of human services or within the bureau of TennCare. The policies and processes may include, but are not limited to, presumptive […]
§ 71-5-1407. Level of Care and Continued Stay Criteria — Preadmission Evaluation (Pae) Assessment Tool
The commissioner shall develop level of care criteria for new nursing facility admissions that ensure that the most intensive level of long-term care services is provided to persons with the highest level of need. The bureau of TennCare shall define the state’s medical eligibility criteria for all long-term care services, including nursing facility and home- […]
§ 71-5-1408. Strategies to Encourage Utilization of Cost-Effective Home and Community-Based Services — Requirements Related to Nursing Facility Diversion
The commissioner shall develop and implement strategies to encourage the utilization of cost-effective home and community-based services in lieu of institutional placement. The commissioner shall specify in contractor risk agreements with integrated long-term care contractors requirements related to nursing facility diversion. The requirements may include, but are not limited to, the following: Documentation prior to […]
§ 71-5-1409. Nursing Facility Transition Initiative
The commissioner shall develop and implement a nursing facility transition initiative. The commissioner shall specify in contractor risk agreements with contractors responsible for coordination of medicaid primary, acute and long-term care services requirements related to nursing facility-to-community transitions. Contractor requirements shall include identification of nursing facility residents who may be appropriate for transition to home […]