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HCBS Remediation Letters for A&D Waiver Providers 2/7/2017

Posted Feb 17, 20173 min Read

Regulatory & Clinical

The Indiana Division of Aging began yesterday to send remediation letters to current Aged & Disabled Waiver providers, including those that provide Assisted Living services on the waiver.  Letters for all providers requiring remediation will be sent out this week, if not by today February 7, 2016.  The letters are based on the results of onsite surveys to determine what remediation, if any, would be required for the provider to remain in compliance with the federal Home and Community Based Settings regulation (the “Settings Rule”).

The letters and the remediation plan template are individualized to the provider based on their survey results.  There is one letter for settings that are presumed institutional and another for those who are not presumed institutional.  Presumed institutional provider will require approval by CMS through the heightened scrutiny process.  Presumed institutional providers are those AL settings that: (1) are co-located with a nursing facility; (2) have a secure memory care, or (3) are both co-located with a nursing facility and have a secure memory care.

Presumed institutional settings are also being removed from the pick list as of March 1, 2017 so that no new waiver consumers can choose that setting until remediation has been completed. The appeal process for this decision is noted in the letter.  Existing consumers may continue to reside in the facility until March 2019, after which they will be relocated unless the provider successfully remediates.

For providers with presumed institutional settings, the provider must notify the Division of Aging that the provider wants to attempt remediation.  The Division will then send the provider a remediation plan template and more instructions around the heightened scrutiny process. The Division’s specific instructions will include evaluation of the provider’s individual situation, number of consumers, etc. and include any additional information.  The Division will also likely reach out directly to the provider for a technical assistance phone call either before or after the provider has submitted their remediation plan.

Each letter contains a website link to a webinar that the Division of Aging has recorded with some explanation about the letter and the survey.  A February webinar will be schedule to walk through the remediation plan in more detail and take some questions. Remediation plans are due April 10, 2017 and remediation must be complete by January 2018.  The Division believes a deadline for remediation of January 2018 will give the Division and providers room for any extensions or further remediation after validation visit(s) are conducted.

Providers should use the email address in the letter to contact the Division of Aging with questions about their specific remediation letter. This will assure a more rapid response.

Below are links to the various letters and tools:
• Remediation Letter for Presumed Institutional Settings
• Remediation Letter for Non-Presumed Institutional Settings
• Remediation Webinar (18 minutes)
• Final Assisted Living Certification Checklist
• Assisted Living Remediation Tool
• Assisted Living Remediation Tool – Completed Example