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MMIS Long-Term Services and Supports Manual

MMIS Long-Term Services and Supports Manual

Assessment results and program types on the long-term care (LTC) screening document

Page posted: 8/3/26

The LTC screening document supports the management and administration of the following program types:

  • · 00: None.
  • · 01: Brain Injury – Nursing Facility (BI-NF) Diversion.
  • · 02: BI-NF Conversion.
  • · 03: Elderly Waiver (EW) Diversion.
  • · 04: EW Conversion.
  • · 05: Community Access for Disability Inclusion (CADI) Diversion.
  • · 06: CADI Conversion.
  • · 07: Community Alternative Care (CAC) Diversion.
  • · 08: CAC Conversion.
  • · 09: Alternative Care (AC) Diversion.
  • · 10: AC Conversion.
  • · 11: BI – Neurobehavioral Hospital (BI-NB) Diversion.
  • · 12: BI-NB Conversion.
  • · 18: Minnesota Senior Health Options (MSHO)/Minnesota Senior Care Plus (MSC+) Community (non-EW).
  • · 19: MSHO/MSC+ NF Resident.
  • · 22: AC Temporary.
  • · 29: Essential Community Supports (ECS).
  • · 30: ECS Transition.

    • Note: The LTC screening document does not support programs associated with developmental disabilities. For more information about DD, refer to DD Screening Document Codebook.

    This page shows the allowable combination of program types with assessment results.

    Program type

    Allowable assessment result/exit reason (ASSESSMENT RESULT/EXIT RSN)

    Program types 01–12, 22, 29 and 30:

  • · BI, CAC, CADI and EW
  • · AC
  • · ECS

    • You can use the following assessment results:

  • · 01: Person will remain in or return to the community with at least one AC/ECS/waiver service (used for opening the person to their first HCBS program).
  • · 10: Person is changing to a different program.
  • · 11: Person is reopening to the same program (use if person ever opened to program).
  • · 12: Service change/functional needs change (AC and EW only).
  • · 13: Person continues on same program at reassessment.
  • · 32: Updated AC financial (AC only).
  • · 49: Citizenship verified (AC and ECS only).
  • · 98: Other (used with activity type 05 screening document field change and for updating ECS financial data).

    • Note: These assessment results are from LTC Screening Document, DHS-3427 (PDF).

    MMIS LTSS Manual – Exit reasons includes descriptions for the following exit reasons:

  • · 17, 19, 20–25 (waiver), 31, 33 or 34 (AC): Exit the program.
  • · 20 or 22–25: Exit ECS.
  • · 53: Temporary waiver exit (not for AC or ECS).

    • Program type 00: Assessed in the community, institution or residential treatment setting

    You can use the following assessment results:

  • · 02: Person will remain in or return to the community with services not funded by AC/ECS or waiver program.
  • · 03: Person will remain in or return to the community without services.
  • · 04: Person will/resides in a nursing facility or certified boarding care.
  • · 05 Person will/resides in a non-certified boarding care.
  • · 06: Person will/resides in an ICF/DD.
  • · 07: Hospital discharge to a nursing facility – short stay of 90 days or less.
  • · 08: Hospital discharge to a nursing facility – long stay of 91 days or longer.
  • · 09: Person will/receives long-term hospitalization.
  • · 18: Transition planning (used to authorize relocation service coordination – targeted case management).
  • · 43: NF visit every 3 years (used for NF visit every two years when combined with activity type 03 or NF visit every three years when combined with activity type 07).
  • · 52: Residential treatment (used when assessed and admitted to or remaining in residential treatment setting).

    • Note: These assessment results are from LTC Screening Document, DHS-3427 (PDF).

    Preadmission screening for program type 00, 19 (MSHO, MSC+) and 28 (SNBC)

    You can use the following assessment results:

  • · 04: Person will/resides in a nursing facility or certified boarding care.
  • · 07: Hospital discharge to a nursing facility – short stay of 90 days or less.
  • · 08: Hospital discharge to a nursing facility – long stay of 91 days or longer.
  • · 29: Undecided/undetermined (only used when the LTCC county field is Senior LinkAge Line [SLL]).

    • Note: These assessment results are from LTC Screening Document – Telephone Screening, DHS-3427T (PDF).

    Additional resources

    LTC Screening Document, DHS-3427 (PDF)
    MMIS LTSS Manual – Exit reasons

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