Changes in Pre-Admission Screening Delayed; MnCHOICES Time Study to Proceed October 1

September 26, 2013

This is an update about implementing Legislative changes to the Pre-Admission Screening (PAS) process and ending the Long Term Care Consultation allocation.  Through training sessions and business process meetings held around the state, many know that during the 2013 legislative session, changes were made to the Long Term Care Consultation statute (Minnesota Statute, Section 256B.0911) and the Minnesota Board on Aging statute (Minnesota Statute, Section 256.975).  These changes redesigned and refinanced the federally mandated Pre-Admission Screening (PAS) process and ended the Long Term Care Consultation allocation.  

These statutory changes were passed under a contingency that requires approval of federal funding from the Centers for Medicare and Medicaid Services (CMS) and the Minnesota Management and Budget department prior to implementation. As of this announcement, positive negotiations continue with CMS but the process is not yet finalized.  Therefore, changes to Pre-Admission Screening and the Long Term Care Consultation allocation will not go into effect October 1, 2013 as stated in statute. Work continues to receive approval from CMS so that 2013 legislative changes can be implemented. More information will be provided as it is available.

How the implementation will proceed:

  • The Pre-Admission Screening changes included shifting the role from the counties to the Senior LinkAge Line® as well as removing an exemption for individuals admitted to a nursing facility for less than 30 days. The changes also included moving this telephone and fax-based process to an online referral page which will be located at Please continue with current policies for requesting and conducting Pre-Admission Screening (see Minnesota Statute, Section 256B.0911.) until notified otherwise.
    • The changes made to the statute also included a method to refinance the way in which Pre-Admission Screening and Long Term Care Consultation (now referred to as MnCHOICES) is reimbursed.  Here is the way in which those payments will be impacted during this transition period: The current method - where nursing facilities pay the counties and the Department of Human Services (DHS) includes an adjustment in the Nursing Facility (NF) payment rates - remains in place.  Rate notices have been issued accordingly
    • After CMS approval and implementation there will be a new method for reimbursement. The NF allocation (current method) will end.  In its place, DHS will pay the counties for assessment on a quarterly basis using the existing federally-approved time studies
    • While changes to the way Long-Term Care Consultation (LTCC) is paid is postponed, DHS will implement the time study October 1, 2013. Therefore it is important for counties to be aware that the time study that was scheduled to begin October 1, 2013 will proceed as planned.
    • However, since the current method is still in place, private-pay residents will need to be billed according to the rate notices that includes LTCC and facilities must make payment to the counties for LTCC services until the contingent items are approved.  Counties must also continue payments on a monthly basis to the area agencies on aging.

Once negotiations are finalized, the NF rate changes will be made but will be retroactive to October 1. For example, if the approval comes after facilities have billed and been paid for October services, DHS will recover the LTCC portion of the payments through an adjustment to Remittance Advices. Private-paying residents must be given refunds. If the resident is still at the facility, it can be done as a credit to the next charge for monthly services. If the person is no longer a resident, a reasonable effort must be made to send the person a refund.  The counties will be instructed to give refunds to NFs for any amounts collected that represent payments due for months beginning October 1 and later.  The Area Agencies on Aging will be instructed to provide a refund to the counties for payments made for months beginning October 1 and later.

For information regarding Pre-Admission Screening changes, please continue to check as up to date information will be posted.

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