Long-term care (LTC) screening document activity type and assessment result combinations
Page posted: 8/3/26
This page provides the correct combinations of activity types and assessment results.
For general information about activity types, refer to MMIS LTSS Manual – LTC screening document activity types. For information about activity type and effective date rules, refer to MMIS LTSS Manual – LTC screening document activity type dates and effective dates.
MMIS will post an exception code if you have an incorrect combination of activity type on the ALT1 screen and assessment result on the ALT4 screen.
Activity type | Allowable assessment results |
01: Telephone activity | For a preadmission screening (PAS) completed for a person seeking nursing facility (NF) admission, you can use the following assessment results: Historically, MCOs also used this activity type for health risk assessments (HRAs) completed by telephone or mailed surveys. |
02: In-person assessment in community | For a person who will remain in the community with a waiver, Alternative Care (AC) or Essential Community Supports (ECS) program that will open within 60 days of the assessment, you can use the following assessment results: For a person who will remain in the community without HCBS services but will receive other services (e.g., state plan home care, services covered under other funding like LTC insurance), you can use the following assessment results: For a person who will be admitted to an institution or residential treatment setting within 60 days of the assessment, you can use the following assessment results: Historically, MCOs also used this activity type for some HRAs. |
03: Visit/early Intervention | For a visit or contact without a completed assessment, you can use the following assessment results: |
04: In-person assessment in institution or residential treatment | For a person who will open to a program, change to a different program or return to their previous HCBS program when they return to the community within 60 days of assessment, you can use the following assessment results: For a person who will return to the community within 60 days of the assessment without HCBS services, you can use the following assessment results: For a person who will receive relocation service coordination – targeted case management (RSC-TCM) or Moving Home Minnesota (MHM) services, you can use the following assessment result: For more information about authorizing RSC-TCM, refer to MMIS LTSS Manual – RSC-TCM. For more information about preparing an LTC screening document to authorize MHM services, refer to MMIS LTSS Manual – MHM services. For a person who will remain in the institution or residential treatment setting, you can use the following assessment results. |
05: Document change | If you need to make a change to non-protected fields on a copy of a saved LTC screening document (e.g., update case manager information), you can use the following assessment result: If you need to make a change on a copy of an AC or ECS screening document, you can use the following assessment results: |
06: Reassessment | For a required reassessment completed at least annually while the person is on an HCBS program, you can use the following assessment results: |
07: Administrative activity | For a person whose participation in an HCBS program will end (i.e., exit or close the program), you can use various reasons associated with closing a program administratively. For more information, refer to MMIS LTSS Manual – Exit reasons and MMIS LTSS Manual – Close an HCBS program. For a person who will open, change to a different program or return to an HCBS program within 60 days of activity type 02, 04 or 09, you can use the following assessment results: For a person who will return to the same HCBS program (does not apply to AC or ECS) within 121 days of a temp exit (assessment result 53) due to a hospital or NF stay you can use the following assessment results: For a person on AC or ECS who needs to update their citizenship status, you can use the following assessment result: For a person who will receive RSC-TCM within 365 days of an in-person assessment, you can use the following assessment result: For more information about returning to Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI) or Elderly Waiver (EW) after hospital or NF admission, changing to EW and/or enrolling in managed care, refer to CBSM – Assessment applicability and timelines. |
08: 65th birthday update | For a person who remains on their current program, you can use the following assessment results: If the person is eligible for and chooses to move to EW, you can use the following assessment result: For more information about 65th birthday assessment policy and timelines, refer to CBSM – Assessment applicability and timelines. |
09: Eligibility updateNote: Only use eligibility updates after initial assessments that occur before July 1, 2025. Use the initial assessment review (IAR) for initial assessments completed on or after July 1, 2025. For more information, refer to CBSM – IAR for HCBS. | For a person who will remain in or return to the community with waiver, AC or ECS services after an eligibility update, you can use the following assessment results: For a person who will remain in or return to the community without HCBS services but may receive other services after an eligibility update (e.g., state plan home care, services covered under other funding like LTC insurance), you can use the following assessment results: When you complete an eligibility update after activity type 04 and the person will remain in an institution or residential treatment setting, you can use the following assessment results: |
10: Service change for AC and EW programs | To update assessment information to accommodate service changes and/or resources, you can use the following assessment result: |
14: Initial assessment review (IAR)Note: Use IARs after initial assessments that occur on or after July 1, 2025. For more information, refer to CBSM – IAR for HCBS. | For a person who will remain in or return to the community with waiver, AC or ECS services after an IAR, you can use the following assessment results: For a person who will remain in or return to the community without HCBS services but may receive other services after an IAR (e.g., state plan home care, services covered under other funding like LTC insurance), you can use the following assessment results: When you complete an IAR after activity type 04 and the person will remain in an institution or residential treatment setting, you can use the following assessment results: |
Additional resources
CBSM – Assessment applicability and timelines
CBSM – IAR for HCBS
MMIS LTSS Manual – Close an HCBS program
MMIS LTSS Manual – Exit reasons
MMIS LTSS Manual – LTC screening document activity types
MMIS LTSS Manual – LTC screening document activity type dates and effective dates
MMIS LTSS Manual – MHM services
MMIS LTSS Manual – RSC-TCM
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