Alternative Care (AC) conversion case management

Page posted: 8/3/26

Conversion case management is similar to relocation service coordination – targeted case management (RSC-TCM). It allows a person on AC to receive case management to assist with relocation. You can either add it to a current AC service agreement or use it to open a person to AC to provide relocation assistance.

The information on this page is about data entry for this specific case management service. For general instructions, refer to MMIS LTSS Manual – Change an existing service agreement, MMIS LTSS Manual – Create a new service agreement and MMIS LTSS Manual – Close a service agreement.

Note: A person receiving only AC conversion case management does not have an AC fee. For information about AC fees, refer to CBSM – AC fees.

Instructions to add conversion case management to an existing AC service agreement

You can authorize AC conversion case management when a person receiving AC services enters a nursing facility (NF) and needs case management to support their relocation back to the community. In this situation, keep the AC program open and add conversion case management to the AC service agreement.

To authorize AC conversion case management:

1. Keep the end date the same at the service agreement header on the ASA1 screen.

2. Change any AC fee information on the ASA2 screen to reflect no fee for the month(s) the person will receive AC conversion case management only.

3. Update the ASA3 screen to:

· End the other AC service agreement line items effective the NF admission date.

· Enter a new line item for conversion case management (T1016 with no modifier).

· Enter the begin date on the line item as the date conversion case management will begin.

4. Press F9 to display exception codes.

5. Resolve exception codes.

6. Press F3 to save the service agreement.

7. Press F3 to continue to log out of MMIS.

MMIS does not:

· Add the cost of the approved conversion case management service line to the TOT AUTH AMT (total authorized amount) field on the ASA1 screen.

· Apply the cost against the CAP AMT (total cap amount) on the ASA1 screen of the service agreement.

A person can receive AC conversion case management for a maximum of 180 days. The authorization cannot exceed the end of the current AC eligibility span. If the person needs to continue AC conversion case management beyond the end date of the current span, you must complete the annual reassessment (activity type 06). Once the AC eligibility span is extended at reassessment, you must enter a new service agreement for additional AC conversion case management.

Instructions when the person discharges from the NF

If the person returns to the community and will continue using AC services:

1. Update the AC fee information on the ASA2 screen, if needed.

2. Update the ASA3 screen to:

· Close the conversion case management line item effective the last day the person received conversion case management, which must be no later than the date of NF discharge.

· Reenter the line items for AC community services.

3. Press F9 to display exception codes.

4. Resolve exception codes.

5. Press F3 to save the service agreement.

6. Press F3 to continue to log out of MMIS.

7. Complete the person’s annual reassessment as usual.

If the person returns to the community and will not continue using AC services:

1. Close the service agreement using the last day conversion case management was provided, which must be no later than the date of NF discharge.

2. Press F9 to display exception codes.

3. Resolve exception codes.

4. Press F3 to save the service agreement.

5. Press F3 to continue to log out of MMIS.

6. Enter an exit screening document to close AC with an effective date no sooner that the end date used on the service agreement. For more information, refer to MMIS LTSS Manual – Close an HCBS program and MMIS LTSS Manual – Close a service agreement.

Instructions to open AC with conversion case management only

A person may open to AC with conversion case management as the only AC service. They may receive conversion case management for up to 180 days during a nursing facility stay to help them relocate to the community.

To open a person to AC with conversion case management only:

1. Complete an in-person assessment.

2. Determine financial eligibility for AC. For instructions, refer to CBSM – AC program.

3. Enter a screening document. For instructions, refer to MMIS LTSS Manual – Enter an LTC screening document.

4. Use activity type 04 on the ALT1 screen.

5. Press the transmit key to move to the ALT2 screen and use:

· 09 (requests relocation) in the REASONS FOR REF field.

· 04 (congregate) in the CURRENT LA field.

· 01, 02, 03, 04, 05 or 06 in the PLANNED LA field (can be any option).

· 02, 03 or 11 in the CURR HOUSING field.

· 04, 05, 09 or 12 in the PLANNED HSNG field.

· Appropriate responses for all other fields.

6. Press the transmit key to move to the ALT3 screen and complete the ALT3 screen based on the assessment.

7. Press the transmit key to move to the ALT4 screen and use:

· 01 (initial program), 10 (change program) or 11 (reopen previous program) in the ASSESSMENT RESULTS/EXIT RSNS field, based on the person’s use of home and community-based services (HCBS) in the past.

· A date in the EFFECTIVE DT field that is up to 60 days from the activity type date of activity type 04, based on when AC conversion case management will begin.

· 09 (AC diversion), 10 (AC conversion if the person has been in the NF for at least 30 days) or 22 (temporary AC if the person must apply or has applied for MA) in the PROGRAM TYPE field, as applicable.

· Appropriate responses for all other fields.

8. Press the transmit key to move to the ALT5 screen and, as an optional step, enter 35-F (case management) in the service plan summary section of the document.

9. Press the transmit key to move to the ALT6 screen and use 04 (person is residing in NF and receiving case management only) in the AC FEE WAIVER REASON field.

10. Press F9 to display exception codes.

11. Resolve exception codes and press F9 after resolving each code.

12. Press F9 after resolving all exception codes to display exception codes for the entire document.

13. Press F3 to save the screening document. This step is important. You must save the document even if exception codes remain. MMIS will save the completed data and allow you to return to the document for additional work.

14. Press F3 to continue to log out of MMIS.

After you save the approved screening document in MMIS:

1. Enter an AC service agreement with a line item for only conversion case management (T1016 with no modifier).

2. Use a service agreement begin date that is no earlier than the effective date on the screening document.

The person can receive AC conversion case management for a maximum of 180 days. If the person continues to be in the nursing facility after 180 days, you must close the service agreement and enter an exit document to close the AC program.

Instructions when the person discharges from the NF within 180 days

If the person returns to the community and will continue using AC services:

1. Update the AC fee information on the ASA2 screen, if needed.

2. Update the ASA3 screen as follows:

· Close the conversion case management line item effective the last day the person received conversion case management, which must be no later than the date of NF discharge.

· Enter the line items for AC community services.

3. Press F9 to display exception codes.

4. Resolve exception codes.

5. Press F3 to save the service agreement.

6. Press F3 to continue to log out of MMIS.

7. Complete the person’s annual reassessment as usual.

If the person returns to the community and will not continue using AC services:

1. Close the service agreement using the last day conversion case management was provided, which must be no later than the date of NF discharge.

2. Press F9 to display exception codes.

3. Resolve exception codes.

4. Press F3 to save the service agreement.

5. Press F3 to continue to log out of MMIS.

6. Enter an exit screening document to close AC with an effective date no sooner that the end date used on the service agreement. For more information, refer to MMIS LTSS Manual – Close an HCBS program and MMIS LTSS Manual – Close a service agreement.

Instructions to change AC conversion case management to RSC-TCM

If the person becomes eligible for MA during the admission, you must discontinue AC conversion case management and replace the support with RSC-TCM services.

To discontinue conversion case management and start RSC-TCM:

1. Close the AC service agreement effective the date of MA eligibility. For more information, refer to MMIS LTSS Manual – Close a service agreement.

2. Enter an exit screening document to close AC using activity type 07. For more information, refer to MMIS LTSS Manual – Close an HCBS program.

3. Enter 19 (exit AC due to change in financial eligibility) in the first ASSESSMENT RESULTS/EXIT RSNS field.

4. Enter the effective date of the exit as the same as the date used to close the AC service agreement.

5. Enter 04, 07 or 08 in the second ASSESSMENT RESULTS/EXIT RSNS field to indicate the NF admission/stay.

6. Enter 38-F on the service plan summary screen.

7. Press F9 to display exception codes.

8. Resolve exception codes.

9. Press F3 to save the service agreement.

10. Press F3 to continue to log out of MMIS.

The person can receive RSC-TCM for a maximum of 180 days. RSC-TCM claims will pay during the 365 days from the date of the last in-person assessment. You might need to complete an activity type 04 assessment if RSC-TCM services and resulting claims will continue beyond that date. For more information, refer to MMIS LTSS Manual – RSC-TCM.

Additional resources

CBSM – AC fees
CBSM – AC program
MMIS LTSS Manual – Change an existing service agreement
MMIS LTSS Manual – Close a service agreement
MMIS LTSS Manual – Close an HCBS program
MMIS LTSS Manual – Create a new service agreement
MMIS LTSS Manual – Enter an LTC screening document
MMIS LTSS Manual – RSC-TCM