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 LT101 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 firstname.lastname@example.org 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 email@example.com or (307) 777-5029.
Medicaid Eligibility for Nursing Facility Residents
The Division does not refer LT101 Level of Care Assessment requests to the County Public Health Nursing Offices for the purpose of nursing facility admission unless the individual to be assessed is a current recipient of Wyoming Medicaid or has applied for Wyoming Medicaid coverage. LT101 Level of Care Assessment requests submitted by nursing facility representatives must indicate whether the individual to be assessed is a current Wyoming Medicaid recipient or has applied for Wyoming Medicaid.
Current nursing facility residents who apply for Medicaid coverage may be assessed for Medicaid nursing facility eligibility once they submit their application for Medicaid. The Division will allow up to ten calendar days for Medicaid eligibility verification to occur before taking action on the LT101 assessment request. If the applicant is not active in the Wyoming Enrollment System (WES) after ten calendar days, the applicant’s LT101 Assessment status will change to “no referral” and the nursing facility representative will be required to verify that the Medicaid application has been received by the Long-Term Care (LTC) Unit before another request for an LT101 Assessment can be submitted.
The HCBS Section does not manage the nursing facility benefit or Medicaid eligibility, and does not have the authority to make retroactive eligibility or nursing facility benefit coverage decisions. Nursing facilities are encouraged to work with the LTC Eligibility caseworker if they need to confirm receipt of a Medicaid Eligibility application or have questions related to Medicaid eligibility. Please contact Amy Guimond (firstname.lastname@example.org), the Medicaid Facilities Manager of the Provider Services Unit, for any questions related to nursing facility reimbursement.
LG-2022-011 – LT101 Assessment 12 Month Validity Guidance – Effective 5/10/2022