− Have a diagnosed degenerative or chronic medical condition requiring nursing services that cannot be provided in a standard ALF but are available in an ALF licensed for LNS or ECC; and − Be a Medicaid-eligible recipient who meets ALF criteria, awaiting discharge from a nursing home but cannot return to a private residence because of a need for supervision, personal care, periodic nursing services, or a combination of the three.
Only facilities with an ECC or LNS and semi-private rooms and bathrooms are allowed to participate in the ALE waiver program.
Nursing Home Admission Policy
Eligibility for the waiver is higher than the nursing home criteria. Waiver eligibility is limited to the following conditions as determined by using the Comprehensive Client Assessment:
Requires assistance with four or more ADLs or three ADLs plus assistance with
administration of medication.
Requires total help with one or more ADLs.
Has a diagnosis of Alzheimer’s disease or another type of dementia and requires
assistance with two or more ADLs.
Has a diagnosed degenerative or chronic medical condition requiring nursing services that cannot be provided in a standard licensed ALF but are available for an ALF that is licensed to provide LNS or ECC services.
Is a Medicaid-eligible resident awaiting discharge from a nursing home who cannot return to a private residence because of the need for supervision, personal care services, periodic nursing services, or a combination of the three.
Is receiving case management and is in need of assisted living services as determined by the community case manager and meets eligibility criteria as determined by the state’s Comprehensive Assessment and Review for Long-Term Care Services (CARES) program.
Four licensure types are available: standard, LNS, limited mental health, and ECC. Standard facilities provide personal care services, and may provide administration of medications if offered by the facility. Facilities with an ECC license may provide a higher level of service and must make available the following additional services if required by the resident’s service plan: total help with bathing, dressing, grooming and toileting; nursing assessments conducted