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MMIS Long-Term Services and Supports Manual

MMIS Long-Term Services and Supports Manual

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:

  • · 04: Will reside or currently resides in NF or certified boarding care.
  • · 07: Hospital discharge to NF less than 90 days.
  • · 08: Hospital discharge to NF greater than 91 days.
  • · 29: Undecided/undetermined (program type 00 only).
  • 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:

  • · 01: Initially open to a program.
  • · 10: Change to a new program, which means the person had been on a different program in the past but is not currently on a home and community-based services (HCBS) program.
  • · 11: Return to previous program, which means the person had been on the same program in the past but is not currently on an HCBS program.
  • 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:

  • · 02: Services but not funded by HCBS.
  • · 03: No services.
  • 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:

  • · 04: Will reside or currently resides in NF or certified boarding care.
  • · 05: Will reside in a noncertified boarding care facility.
  • · 06: Will reside in an intermediate care facility for persons with developmental disabilities (ICF/DD).
  • · 07: Hospital discharge to NF less than 90 days.
  • · 08: Hospital discharge to NF greater than 91 days.
  • · 09: Will receive long-term hospitalization.
  • · 52: Residential treatment.
  • 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:

  • · 03: In community, no services.
  • · 05: Will reside or currently resides in non-certified boarding care.
  • · 43: Person younger than age 65 in nursing facility declines annual visit.
  • 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:

  • · 01: Initially open to a program.
  • · 10: Change to a new program, which means the person had been on a different program in the past but is not currently on an HCBS program.
  • · 11: Return to previous program, which means the person had been on the same program in the past but is not currently on an HCBS program.
  • 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:

  • · 02: Services not funded by HCBS.
  • · 03: In community, no services.
  • 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:

  • · 18: Transition planning.
  • 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.

  • · 04: Will reside or currently resides in NF or certified boarding care.
  • · 05: Will reside in a noncertified boarding care facility.
  • · 06: Will reside in an ICF/DD.
  • · 07: Hospital discharge to NF less than 90 days.
  • · 08: Hospital discharge to NF greater than 91 days.
  • · 09: Will receive long-term hospitalization.
  • · 52: Residential treatment.
  • 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:

  • · 98: Other.
  • If you need to make a change on a copy of an AC or ECS screening document, you can use the following assessment results:

  • · 32: Changes to the AC gross income/assets or adjusted income/assets fields.
  • · 98: Change to the ECS gross income/assets or adjusted income/assets fields.
  • 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:

  • · 13: Continue on same program.
  • · Various reasons associated with closing a program at reassessment. For more information, refer to MMIS LTSS Manual – Exit reasons and MMIS LTSS Manual – Close an HCBS program.
  • 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:

  • · 01: Initially open to a program.
  • · 10: Change to a new program, which means the person had been on a different program in the past but is not currently on an HCBS program.
  • · 11: Return to previous program, which means the person had been on the same program in the past but is not currently on an HCBS program.
  • 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:

  • · 54: Waiver restart.
  • For a person on AC or ECS who needs to update their citizenship status, you can use the following assessment result:

  • · 49: Citizenship status for people on AC and ECS.
  • For a person who will receive RSC-TCM within 365 days of an in-person assessment, you can use the following assessment result:

  • · 18: Transition planning.
  • 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:

  • · 13: Continue on program.
  • · Various reasons associated with closing a program at the 65th birthday assessment. For more information, refer to MMIS LTSS Manual – Exit reasons and MMIS LTSS Manual – Close an HCBS program.
  • If the person is eligible for and chooses to move to EW, you can use the following assessment result:

  • · 23: Exited; chose to leave program.
  • For more information about 65th birthday assessment policy and timelines, refer to CBSM – Assessment applicability and timelines.

    09: Eligibility update

    Note: 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:

  • · 01: Initially open to a program.
  • · 10: Change to a new program, which means the person had been on a different program in the past but is not currently on an HCBS program.
  • · 11: Return to previous program, which means the person had been on the same program in the past but is not currently on an HCBS program.
  • 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:

  • · 02: Services not funded by HCBS.
  • · 03: In community, no services.
  • 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:

  • · 04: Will reside or currently resides in NF or certified boarding care.
  • · 05: Will reside in a noncertified boarding care facility.
  • · 06: Will reside in an ICF/DD.
  • · 07: Hospital discharge to NF less than 90 days.
  • · 08: Hospital discharge to NF greater than 91 days.
  • · 09: Will receive long-term hospitalization.
  • · 52: Residential treatment.
  • 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:

  • · 12: Service change.
  • 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:

  • · 01: Initially open to a program.
  • · 10: Change to a new program, which means the person had been on a different program in the past but is not currently on an HCBS program.
  • · 11: Return to previous program, which means the person had been on the same program in the past but is not currently on an HCBS program.
  • 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:

  • · 02: Services not funded by HCBS.
  • · 03: In community, no services.
  • 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:

  • · 04: Will reside or currently resides in NF or certified boarding care.
  • · 05: Will reside in a noncertified boarding care facility.
  • · 06: Will reside in an ICF/DD.
  • · 07: Hospital discharge to NF less than 90 days.
  • · 08: Hospital discharge to NF greater than 91 days.
  • · 09: Will receive long-term hospitalization.
  • · 52: Residential treatment.
  • 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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