7.00 Appendix 7 Ombudsman SMH/MFP Referral Instructions
Home and Community Based Services Manual
7.00 Appendix 7 Ombudsman SMH/MFP Referral Instructions
The Missouri Long-Term Care Ombudsman Program (LTCOP) recruits and trains volunteers that visit residents in all types of long-term care facilities. These volunteers may interact with residents in Skilled Nursing Facilities (SNF) that express a desire to return to the community. When that happens, the volunteer contacts the Regional Ombudsman Coordinator (ROC) and a Show-Me Home (SMH)/Money Follows the Person Demonstration (MFP) referral is made on the resident’s behalf.
Instructions
Completed by the ROC
- Name
- Email to SMH@health.mo.gov
- Date completed
Referral Section
Completed by the ROC
- Facility name, address, and telephone number
- Resident’s name, date of birth, SSN, and DCN
- Date resident entered the facility
- Resident’s health conditions and other information that could impact the ability to return to a community setting
- Additional pages may be attached if necessary.
Disposition Section
Completed by the Show Me Home (SMH) Services Specialist within 30 days of the date of referral
- Indicate if the resident is eligible
- Indicate date of enrollment for SMH services
- Indicate if the resident is not enrolled in SMH and check all applicable reasons
- Indicate if the participant is approved for MFP but does not meet level of care (LOC) to receive Home and Community Based Services (HCBS)
- Enter the SMH Service Specialist's name and telephone number
Comments
Comments may be entered by the ROC and/or the SMH Services Specialist as necessary. Information could include details on the resident’s community support network, needed resources, potential challenges to transition, etc. Additional pages may be attached if necessary.
Distribution
Upon completion by the ROC the following shall occur:
- The referral is faxed to SMH DSDS oversight staff
- SMH DSDS oversight staff forwards to the appropriate SMH Services Specialist
At disposition, the following shall occur:
- The SMH Services Specialist or DSDS staff shall fax a copy back to SMH DSDS oversight staff
- Ensure a copy is uploaded to the participant’s electronic case record when applicable
SMH DSDS oversight staff shall:
- Provide a copy of the completed form to State LTCOP staff