The article below is a top story from this week's ACTION newsletter—Care Providers of Minnesota's weekly newsletter for members. The newsletter focuses on current legislative issues, regulations, long-term care trends, and other Association news. Each Thursday evening, it is delivered to your inbox. To sign up for ACTION, contact Lisa Foss Olson (952-851-2483). To learn more about membership, visit our Become a Member page.
Update on timely assessments, financial determinations & service authorizations
By Todd Bergstrom | February 7, 2025 | All members
Late in 2024, Care Providers of Minnesota convened a member taskforce to respond to the noticeable increase in members contacting the Association and asking for ideas and/or help in trying to make a county, health plan, or third-party case manager respond or complete some part of a Medicaid client’s financial determination, assessment, or service authorization. The LTC Medicaid Applications and Case Management Taskforce has met five times to date. The initial couple of meetings were spent identifying the issues that residents, their families, and providers are encountering with counties, health plans, and case management agencies.
The taskforce determined that a survey of members was needed if advocacy was to be successful. Care Providers of Minnesota, along with our LTC Imperative partners, conducted a joint survey of assisted living facilities and nursing facilities. The survey findings validated the issues identified by the taskforce. Overall findings include the following:
- The Medicaid application and authorization process is a significant problem for most nursing facilities and assisted livings
- The timing of Medicaid application approval is excessively long, especially in some counties creating access issues for Medicaid pending and financial challenges for the provider
- Most providers give their counties “fair” or “poor” ratings for processing applications, with the metro counties especially low
- Communication of end of MSHO nursing home liability is not happening consistently
- Assisted living report many issues with Medicaid process but the biggest is timing of service agreement completion
- Counties are completing MN Choices assessments on time (within 20 days) at an abysmal rate of just over 10%
Care Providers of Minnesota staff have presented these findings to the Minnesota Department of Human Services (DHS). The state and the Association will continue to meet and discuss areas for improvement.
The survey data and other resources are now posted to the
Association’s website. Here is what you will find posted:
Please contact Todd Bergstrom at the Association office if you have any questions.
Todd Bergstrom | Director of Research & Data Analysis | tbergstrom@careproviders.org | 952-851-2486