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 a 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 happens when someone is deemed ineligible and how are they notified?
A letter is generated by staff from the case management information system to notify the person of the determination and their right to request 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. However, this system revision will take some time to implement.
Verification of Medicaid Eligibility Application
Effective immediately, and until an EMWS update is implemented to address the addition of “Pending Medicaid Application” status on the LT101 request, when a Nursing Facility LT101 request is submitted and the field ‘Is client applying for Medicaid?’ is marked ‘Yes’:
- The Division will verify that a Medicaid Eligibility (ME) application has been received via the Wyoming Eligibility System (WES). If there is not a record of the ME application in WES, the LT101 request will be held until the 3rd calendar day, which is the Division timeline to make referrals. This will allow more time for the ME application to reach the eligibility office.
- On the 3rd calendar day, the ME application will be re-verified. If there still is not a record of the ME application in the WES system, the LT101 request will be marked as ‘No Referral’, with the following reason listed: No record of a ME application on file. Please verify the ME application has been received by the LTC Eligibility Unit before submitting a new LT101 request.
Nursing facilities are encouraged to work with the LTC Eligibility caseworker if they need to confirm receipt of a ME application. It is the nursing facility’s responsibility to ensure that the ME application has been received prior to submitting an LT101 request.
The Community-Based Services Unit (CBSU) does not manage the nursing facility benefit or the Medicaid eligibility and does not have the authority to make retroactive eligibility or nursing facility benefit coverage decisions. Please contact the Medicaid Facilities Manager of the Provider Services Unit for any questions related to nursing facility reimbursement and/or the LTC Medicaid Eligibility caseworker for assistance with any questions related to Medicaid eligibility.