The Bureau of Long Term Care administers the program that reimburses more than 750 nursing facilities (NFs) for care provided to approximately 57,000 Medicaid-eligible residents each month. You can access brochure HFS 3191 Nursing Home Services and Information for Couples for more information.

Bureau staff consists of central office and field staff. Central office staff is responsible for developing policy in accordance with state and federal regulations, enrolling providers and ensuring that sanctions set by the Department of Public Health are implemented. Staff also works with billing issues to ensure that correct payment to providers is made by a system of ongoing pre- and post-payment review adjustments, as well as entering bed hold data, providing billing assistance and information to providers, resolving billing discrepancies and coordinating billing with the Department of Human Services local offices.

Field staff provides technical assistance to NFs when required by findings identified during surveys performed by the Department of Public Health. Field staff also completes post-payment audits of bed reserves; works with supportive living facilities (SLFs), both before and after opening, to ensure compliance with regulations; assists NFs with submission of the Minimum Data Set and assists NFs enrolled in the mental health demonstration project. Field staff provides support services to the Office of the Inspector General, Bureau of Medicaid Integrity, when requested. Field staff also provides ongoing assistance with the Bureau of Interagency Coordination in monitoring Home and Community-Based Services waivers. Staff is also responsible for the Exceptional Care Program, which provides enhanced reimbursement to participating nursing facilities for care provided to residents that require extraordinarily high-cost care that would result in difficulty accessing care. These areas of care include persons suffering from head trauma/spinal cord injury, persons with AIDS, multiple complex medical needs, complex respiratory care and ventilator-dependent persons.

The Supportive Living Program is a service-enriched housing option available to Medicaid-eligible individuals that allows elderly, age 65 years and older, or adults, ages 22 – 64 years, with disabilities who would otherwise need nursing facility care. SLFs consist of apartments with kitchenettes and private bathrooms while providing services such as intermittent nursing, personal care, medication oversight, meals, housekeeping, laundry and 24-hour security.

The bureau is also responsible for the oversight of the Program of All-inclusive Care for the Elderly (PACE) which is a managed care model of acute and long-term care that integrates the provision and financing of medical and long-term care services. PACE provides its participants with access to medical care and links other services 24 hours a day, and is paid a capitated rate for each participant.