Minnesota Minnesota

MMIS Long-Term Services and Supports Manual

MMIS Long-Term Services and Supports Manual

Managed care use of the long-term care (LTC) screening document

Page posted: 8/3/26

This page includes instructions for:

  • · Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+) staff.
  • · Special Needs BasicCare (SNBC) staff.
  • · Essential Community Supports (ECS) program transitions.
  • · Health risk assessments (HRAs) and waivers.
  • · Managed care organization (MCO) monthly capitation payments.
  • General instructions for MSHO and MSC+ staff

    In-person assessments and eligibility updates

    MSHO and MSC+ staff use the LTC screening document in the same ways as county and Tribal Nation staff for many activities. They:

  • · Enter all in-person MnCHOICES assessments using activity type 02 or 04 in the same way as county and Tribal Nation staff, using the same assessment results.
  • · Enter eligibility updates using activity type 09 in the same way as county and Tribal Nation staff, using the same assessment results.
  • When MSHO and MSC+ staff complete a MnCHOICES assessment using activity type 02 for a person in the community and they do not open to Elderly Waiver (EW), MSHO and MSC+ staff use program type 18.

    Note: Program type 18 was previously used for HRAs completed in the community and entered into MMIS.

    For instructions, refer to MMIS LTSS Manual – Work with the LTC screening document.

    EW services

    The benefit set for people enrolled in MSHO and MSC+ includes EW services. For people on EW, MSHO and MSC+ staff:

  • · Determine and document EW eligibility using activity type 02, 04, 09 or 07.
  • · Enter reassessments for EW using activity type 06 in the same way as county and Tribal Nation staff.
  • · Close EW with activity type 06 or 07 in the same way as county and Tribal Nation staff, using the same exit reasons.
  • · Use activity type 05 and 07 for EW in the same way as county and Tribal Nation staff.
  • For instructions, refer to MMIS LTSS Manual – Work with the LTC screening document.

    Other uses

    MSHO and MSC+ staff use activity type 01 and 04 and program type 19 for:

  • · MSHO and MSC+ nursing facility preadmission screening (PAS).
  • · Assessments completed for people during institutional stays.
  • · Provision of relocation service coordination – targeted case management (RSC-TCM).
  • General instructions for SNBC staff

    SNBC staff use activity type 01 and program type 28 when they complete PAS for people enrolled in SNBC.

    Instructions for ECS program transitions

    People who transitioned to ECS using program type 30 can be enrolled in MSHO, MSC+ or SNBC. The county/Tribal Nation manages the ECS transition program for people enrolled in SNBC. DHS enters service agreements into MMIS for people in the ECS transition program and MSHO/MSC+ while they are enrolled with any MCO. For information about ECS, refer to CBSM – ECS.

    For the ECS transitional program type 30, MSHO/MSC+ staff can:

  • · Complete the reassessment and continue the person on the program with activity type 06 (reassessment) and assessment result 13.
  • · Close the program using activity type 06 or 07 and any exit reason.
  • · Use activity type 05 with the same limitations as county and Tribal Nation staff to change some fields in MMIS.
  • Instructions for HRAs and waivers

    An HRA is required for people enrolled under MSHO, MSC+ or SNBC during any of the following circumstances:

  • · At initial enrollment.
  • · On an annual basis.
  • · If the person changes products or MCOs.
  • MCOs use MnCHOICES to complete HRAs. Previously, MCOs entered HRAs into MMIS, so you might notice these types of screening documents in a person’s screening document history. The document type field on the ASCR (screening document) key panel screen is "H". When these documents were saved in MMIS, MMIS showed them on the selection screen as type L-H. These HRA documents do not follow the same rules as the type L screening documents.

    You do not have to delete type L-H document(s) to enter a missing document.

    Instructions for MCO monthly capitation payments

    The MCO receives a monthly capitation amount paid for each person enrolled. MMIS determines the payment amount six days before the next month.

    For capitation dates, refer to the managed care key dates section on DHS – Health plan systems workgroup information.

    MSHO-specific information

    For people on MSHO, the capitation payment is determined by the person’s rate cell. Each rate cell has a different payment rate. There are four rate cells for MSHO:

  • · Rate cell A for people with a living arrangement in the community with no open EW waiver span.
  • · Rate cell B for people with a living arrangement in the community with an open EW waiver span.
  • · Rate cell C for people age 65 and older who are eligible for Moving Home Minnesota (MHM) services while open to EW.
  • · Rate cell D for people with a living arrangement of institutional and no open EW waiver span.
  • For rate cell B, the EW eligibility span must include the following month for the current month’s capitation assignment. If the eligibility span does not include the following month, the rate cell will change to A for the following month. It is important to complete reassessments and enter reassessment screening documents into MMIS in a timely manner before the capitation date of that month to avoid changing the rate cell from B to A.

    MSC+-specific information

    For people on MSC+, the capitation payment is determined by the person’s product ID:

  • · MA35 means an open EW waiver span is present in MMIS on the day of capitation.
  • · MA30 means no open EW waiver span is present in MMIS on the day of capitation.
  • Timely entry of screening documents for assessments and reassessment screening will determine if the EW eligibility span is open on the day of capitation.

    If you enter MMIS documentation late, capitation does not correct retroactively. The MCO must continue to pay for EW services to meet the person’s needs, regardless of the rate cell or capitation paid. EW services must begin on or after the effective date of the person’s eligibility for the EW program.

    Additional resources

    CBSM – ECS
    DHS – Health plan systems workgroup information
    MMIS LTSS Manual – Work with the LTC screening document
    MMIS LTSS Manual – Managed care and MMIS

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