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SA recipients (with the exception of those residing in Residential Hospice facilities are eligible for Medicaid funded personal care services provided by the facility.
Recipients qualifying for Medicaid coverage of Personal Care Services (PCS) are eligible for 1.1 hour of Basic Personal Care per day. Basic Personal Care includes a variety of assistance, including help with bathing, dressing, transferring, etc.
Enhanced Personal Care includes assistance for residents with extensive or total needs in the areas of eating, toileting, and/or ambulating/locomotion. The Adult Care Home Case Manager verifies the need for Enhanced Personal Care.
Medicaid payments for Basic and Enhanced Personal Care services are made directly to the facility. No action is required by the SA caseworker for personal care services other than to ensure that the ambulation capacity is coded correctly in EIS.
Refer to the Division of Medical Assistance web page on clinical services in adult care homes for more information about Enhanced Personal Care.
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office.
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