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Exit reasons

Page posted: 8/3/26

This page defines various exit reasons (also called assessment results), activity type combinations and associated advance notice requirements.

For more information about advance notice requirements, refer to CBSM – Notice of action. For more information about how to exit a person from a home and community-based services (HCBS) program, refer to MMIS LTSS Manual – Close an HCBS program.

Exit reason code

Use with activity type 06 (reassessment)?

Use with activity type 07 (case management or administrative activity)?

Notes

17: Not financially eligible for current HCBS program

Yes, you can use this exit code with activity type 06.

Advance notice

Advance notice is required if the person is exiting at reassessment.

Example: At reassessment, a person on Alternative Care (AC) or Essential Community Supports (ECS) exceeds AC or ECS financial eligibility threshold, which means they also do not meet Medical Assistance (MA) financial eligibility. They must exit AC or ECS.

Advance notice is required because the person could appeal the financial eligibility determination.

Effective date

The effective date must adhere to advance notice requirements. For AC and ECS, the effective date cannot be retroactive.

Yes, you can use this exit code with activity type 07.

You must use activity type 07 when the financial worker informs you that MA is closed or will be closing.

Advance notice

Advance notice is not required. You must still give notice that the HCBS program will be or has been discontinued.

Effective date

The effective date of the exit is limited to the last day of the month that follows the current month. This is always the limit when there is no advance notice requirement.

The effective date can be retroactive. It might be retroactive when the person’s MA eligibility has ended, and their waiver must be closed effective the last day of MA financial eligibility.

You can use this exit code if the person:

· Lost financial eligibility for their current program.
Example: A person on the Elderly Waiver (EW) has a spouse who died and allocated income or asset transfers back to them, making them ineligible for EW. In this case, the person may meet the AC financial threshold.

· Remains eligible for MA but is no longer eligible for MA long-term care (e.g., improper asset transfer discovered).

19: Exit AC, exit AC to open to EW or other AC uses

This exit code supports the following changes in program:

· Move from AC to EW.

· Move from temporary AC to regular AC or EW.

· Move from AC to temporary AC.

Note: You can only use this code for AC.

Yes, you can use this exit code with activity type 06.

Advance notice

Advance notice is not required. You must still give notice about the change in program.

Effective date

The effective date of the exit is limited to the last day of the month that follows the current month. This is always the limit when there is no advance notice requirement.

The effective date cannot be before the activity type date for activity type 06.

Yes, you can use this exit code with activity type 07.

Advance notice

Advance notice is not required. You must still give notice about the change in program.

Effective date

The effective date of the exit is limited to the last day of the month that follows the current month. This is always the limit when there is no advance notice requirement.

The effective date can be retroactive to the MA start date when used to move from AC to EW. A retroactive effective date may require takeback of claims paid under AC.

When you use exit code 19, you can only use exit code 10 (change program) or 11 (return to previous program) in the second assessment result field (field 75B on DHS-3427), as is required for all exits.

You can use exit code 19 when the person:

· Is no longer financially eligible for AC, often due to exhausting their resources, and is now likely eligible for MA. In this situation, the person typically moves to EW when MA is approved.

· Exits temporary AC and changes their program to regular AC or EW after the MA decision is made. This is for new applicants initially opened to temporary AC pending MA application.

· Appears to be eligible for MA at time of the AC reassessment and now needs to apply for MA. In this situation, you close AC and open temporary AC while the person applies for MA.

You cannot use this exit code to move a person from EW to AC when the person is no longer eligible for MA. Instead, refer to exit code 17 for loss of MA.

20: Change in level of care (LOC)

Examples of change level of care include:

· Hospital (CAC) to nursing facility (CADI).

· BI nursing facility (BI-NF) to BI-neurobehavioral hospital (BI-NB).

· Nursing facility (CADI) to hospital (CAC).

· No LOC (ECS) to nursing facility (AC).

Yes, this exit code is only allowed with activity type 06.

Advance notice

Advance notice is required.

Effective date

The effective date cannot be retroactive.

No, this exit code is not allowed with activity type 07.

You can only determine an LOC change at reassessment.

This is the only exit code that allows you to change the person’s LOC and exit ECS, CADI, CAC, BI-NF or BI-NB on the same screening document at reassessment. To change the LOC to “none,” refer to exit code 21.

You can use this exit code if the person’s LOC changed at reassessment. You must enter the correct LOC determined at reassessment and exit the person from the current program on the same screening document.

You can use exit code 20 to indicate the new LOC. Combine it with exit code 10 (changing program) or 11 (returning to program) in the second assessment result field (field 75B on DHS-3427). This allows you to use activity type 07 on a second screening document to open or reopen a new program that is based on a change in LOC without entering a second activity type 06 screening document.

21: No LOC

Yes, this exit code is only allowed with activity type 06.

Advance notice

Advance notice is required. State law requires 30-60 days advance notice.

Effective date

The effective date must be at least 30 and no more than 60 days in the future to meet the advance notice requirements for this exit code, per statute.

No, this exit code is not allowed with activity type 07.

You can only determine a person does not meet LOC criteria at reassessment.

You can use this exit code if the person meets no LOC criteria at reassessment. It changes the LOC field to 07 (none).

Example: You can use this exit code to move a person from AC to ECS.

Note: MMIS will post exception code 171 if LOC is 07 (none) and the assessment information indicates the person meets nursing facility LOC criteria.

22: Person does not/no longer meets other required program criteria, other than loss of financial eligibility for HCBS (use code 17 or 19 instead) or LOC (use code 21 instead)

Yes, you can use this exit code with activity type 06.

Advance notice

Advance notice is required.

Effective date

The effective date cannot be retroactive if used at reassessment.

Yes, you can use this exit code with activity type 07.

Advance notes

Advance notice is required for all underlying exit reasons, except when closing AC because of an institutional or residential treatment admission of more than 30 days. In this AC situation, advance notice is not required, but notice is still required.

Effective date

The effective date can be retroactive only when closing AC because of an institutional or residential treatment admission of more than 30 days.

You can use this exit code if a person:

· No longer needs a waiver/AC service.

· Has Housing Support specialized service and is not eligible for a waiver.

· Has an alternative payer, such as LTC insurance.

· No longer meets BI-NF behavior criteria but has no change in LOC (i.e., moves to CADI).

· Moves from CADI to EW at their 65th birthday.

· Is on AC and is admitted to a nursing facility, hospital or residential treatment for more than 30 days, so they no longer meet criteria for community living arrangement.

For NF admission on ECS, refer to exit code 24.

For institutional or residential treatment admissions on BI, CAC, CADI and EW, refer to exit code 53.

23: Exited by choice

Yes, you can use this exit code with activity type 06.

Advance notice

Advance notice is required.

Effective date

The effective date cannot be retroactive.

Yes, you can use this exit code with activity type 07.

Advance notice

Advance notice is required.

If a person calls and wants to exit their program, you still must provide advance notice.

Effective date

The effective date cannot be retroactive.

N/A

24: Other reasons

Use this code only for the following reasons for closing a program:

· Incarcerated.

· Unable to locate.

· Moved out of state.

· Death, used in combination with exit code 30.

· Exit from ECS to allow Minnesota Aging Pathways (formerly Senior LinkAge Line) to enter a preadmission screening (PAS) document for NF admission.

No, this exit code is not allowed with activity type 06.

Yes, you can use this exit code with activity type 07.

Advance notice

It is not possible to give advance notice in all cases. You must still provide notice when possible.

Effective date

The effective date of the exit is limited to the last day of the month that follows the current month, except for death.

The effective date can be retroactive to the date of the event.

ECS-specific information

When you exit a person from ECS at NF admission:

· Use activity type 07 (administrative activity), assessment result 24 (other) and exit code 04 (NF admission) to complete the exit document.

· Use the date of admission to the NF as the effective date.

Before Minnesota Aging Pathways can enter an activity type 01 for PAS, you must exit the person from ECS.

There is no 30-day window in which a person on ECS can remain on ECS while admitted to an NF because ECS is based on “no LOC.”

When a person on ECS has had a PAS via Minnesota Aging Pathways, the Minnesota Aging Pathways staff will notify the county about the PAS and LOC determination.

The person must receive an in-person assessment to determine any other HCBS program eligibility at discharge.

25: Exited, services never used

No, this exit code cannot be used with activity type 06.

Yes, you can use this exit code with activity type 07.

Advance notice

Notice is required. Advance notice may be provided, depending on why the person never started the program.

Effective date

The effective date is typically the same as opening date.

You can use this exit code if the person never received any HCBS services, including case management.

This exit code allows the EW slot to be returned for statewide use immediately.

31: AC exit for no fee payment for 60 days

Note: You can only use this code for AC.

Yes, you can use this exit code with activity type 06.

Advance notice

Advance notice is required.

Effective date

The effective date cannot be retroactive.

Yes, you can use this exit code with activity type 07.

Advance notice

Advance notice is required.

Effective date

The effective date cannot be retroactive.

You can use this exit code if, at reassessment, the person does not agree to a payment plan and has not paid any fee for 60 days or more.

A person can continue on AC as long as they are paying some amount if they are responsible for a fee.

For more information about AC fees, refer to CBSM – AC fees.

33: AC exit, person declined based on estate claim requirement

Note: You can only use this code for AC.

Yes, you can use this exit code with activity type 06.

Advance notice

Advance notice is required.

Effective date

The effective date cannot be retroactive.

Yes, you can use this exit code with activity type 07.

Advance notice

Advance notice is required.

Effective date

The effective date cannot be retroactive.

You can use this exit code if the person no longer wants to participate in AC because of concerns about estate claims.

34: AC exit, person declined based on AC fees

Note: You can only use this code for AC.

Yes, you can use this exit code with activity type 06.

Advance notice

Advance notice is required.

Effective date

The effective date cannot be retroactive.

Yes, you can use this exit code with activity type 07.

Advance notice

Advance notice is required.

Effective date

The effective date cannot be retroactive.

You can use this exit code if the person no longer wants to participate in AC because of the fee amount.

For more information about AC fees, refer to CBSM – AC fees.

53: Temporary waiver exit

No, you cannot use this exit code with activity type 06.

Yes, you can use this exit code with activity type 07.

Advance notice

Notice is required.

Effective date

The effective date is always retroactive to the date of admission.

You can use this exit code if a person on BI, CAC, CADI or EW has been admitted to an NF, hospital or residential treatment setting for more than 29 days.

This exit code allows the lead agency to restart the person’s previous waiver program if they are discharged within 121 days of admission without completing an assessment by using activity type 07.

If you use any other exit code at admission, you cannot restart the person’s waiver at discharge without completing an assessment.

Use this exit code for all NF, hospital and residential treatment setting admissions of people on BI, CAC, CADI or EW, regardless of the anticipated length of additional stay in the setting.

For more information, refer to CBSM – Temporary waiver exits and restarts: MMIS actions.

Additional resources

CBSM – AC fees
CBSM – Notice of action
CBSM – Temporary waiver exits and restarts: MMIS actions
MMIS LTSS Manual – Close an HCBS program

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