Strategies to Encourage Utilization of Cost-Effective Home and Community-Based Services — Requirements Related to Nursing Facility Diversion

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  1. The commissioner shall develop and implement strategies to encourage the utilization of cost-effective home and community-based services in lieu of institutional placement.
  2. The commissioner shall specify in contractor risk agreements with integrated long-term care contractors requirements related to nursing facility diversion. The requirements may include, but are not limited to, the following:
    1. Documentation prior to approval of nursing facility admission that an individual and the individual's family or other caregivers have been advised of home and community-based alternatives and that the alternatives are not appropriate, cost-effective or desired; and
    2. A requirement for care coordinators to work with hospital discharge planners and to provide face-to-face visits in nursing facilities within a minimum number of days following admission to develop a plan, as appropriate, for transition back to a home or community-based setting.


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