The LT101 Level of Care Assessment instrument was developed by the Division of Healthcare Financing (Division) to establish standardized methods for measuring an individual’s level of functional impairment and to ensure statewide consistency in the level of care evaluation process. The information obtained from the LT101 Level of Care Assessment instrument is used in the Division’s determination of whether an applicant or participant requires, or continues to require, the services or level of care provided in a nursing facility.
LT101 Frequently Asked Questions (FAQs)
Does the LT101 assess a span of time or a specific point in time?
The LT101 is a “point-in-time” assessment and is meant to capture the typical ability of an individual to function across each domain. Public health nurses (PHNs) are instructed to use their best clinical judgement to determine the individual’s typical functioning, and document the rationale for their determination, taking into account potential day-to-day variations due to an individual’s health or ability fluctuations.
When is an LT101 assessment needed?
An LT101 assessment is needed for current and prospective nursing facility residents who are applying for Medicaid coverage and for determining whether an individual meets, or continues to meet, the nursing facility level of care criteria for certain Medicaid programs, such as the Community Choices Waiver (CCW). It is also a required assessment for Pre-admission Screening and Resident Review (PASRR) Level II screenings.
Who performs an LT101 assessment?
Registered nurses licensed to practice in the State of Wyoming who are employed or contracted by a County Public Health Nursing Agency and who are trained to conduct the LT101 assessment.
What is the timeline to process the LT101 request and complete the assessment?
LT101 assessments are under state oversight of the Level of Care (LOC) Assessment Coordinator at the Division. The State has three (3) business days to refer LT101 requests to the PH office and the PHN has seven (7) calendar days from the date of the Division referral to complete and enter the LT101 assessment. If the assessment cannot be completed within that time frame, the PHN may request an extension in the Electronic Medicaid Waiver System (EMWS).
What is the validity of an LT101 assessments?
- The validity of the nursing facility (NF) LT101 is 12 months. The Division will not process any request for an LT101 if a valid assessment has been conducted within the last 12 months.
- A transfer between the Community Choices Waiver (CCW) program to Medicaid State Plan nursing facility (NF) will use and accept a valid LT101 that is less than 365 days old.
- CCW LT101 – Initial applicants and renewal valid LT101 assessments has a validity of 12 months
- PASRR Level II LT101 request – if a valid LT is on file within the last 12 months, no PASRR is required.
What happens when someone is deemed ineligible and how are they notified?
For both NF and CCW, if an LT101 assessment finds an individual ineligible, both have a validity of 90days and a letter is generated by staff from the case management information system to notify the person of the determination and their right to re-apply, or request a reconsideration or appeal Medicaid’s determination by requesting a fair hearing.
For those who request a reconsideration, a second LT101 assessment is conducted. Individuals determined not to meet the nursing facility level of care are notified by a system generated letter. Those who disagree with the reconsideration results may request a fair hearing.
How to request a Nursing Facility (NF) LT101 user login request?
To request a NF LT101 user login, please email email@example.com and provide the name, title, facility name, county, email address, and direct phone line. After verification of information, you will be provided with the sign up instructions.
Who do I contact for a password, login, or system issues?
Please email the helpdesk for any issues with passwords (to reset or unlock), user login or system issues.
Who do I contact for questions about an LT101 assessment?
For questions related to the LT101 assessment, please contact the Level of Care Assessment Coordinator at firstname.lastname@example.org or (307) 777-5029.
Non-Binding Medicaid Admissions
Pursuant to the Level of Care Assessment for Nursing Facility Admissions bulletin distributed March18, 2020, the Division no longer conducts “Admission LT101s.” In response to inaccurate information related to Medicaid application status submitted by some facilities, the Division will not make referrals until the Medicaid application has been confirmed by the Long Term Care (LTC) Eligibility Unit. An EMWS revision to add a “Pending Medicaid Application” status to the LT101 request is in process, so that those requests can be set aside for a specified time period before a referral decision is made and the Division is not held to the 3-day timely processing policy.
Verification of Medicaid Eligibility Application
The Home and Community Based (HCBS) Services Section has recently added a “Pending Medicaid Application” task to the EMWS system. This process will take precedence over our previous interim procedures for nursing facility (NF) LT101 assessment requests that are submitted when a participant is applying for Medicaid. This change will allow NF LT101 assessment requests to be held for a maximum of ten (10) calendar days in order for applications to be verified in the Long-term Care, Wyoming Eligibility System (WES) database. Please adhere to the procedures and information of the LOC-2020-PB02 LT-101 10 Day Eligibility Task Changes effective 12-1-20.
LG-2022-011 – LT101 Assessment 12 Month Validity Guidance – Effective 5/10/2022