Michigan Medicaid Nursing Facility Level of Care Determination (LOCD)

Individuals seeking Medicaid reimbursed long-term services and supports from a Medicaid-certified nursing facility, the Program of All-Inclusive Care for the Elderly (PACE), the MI Choice Waiver Program, or MI Health Link must meet the Medicaid State Agency’s definition of Nursing Facility (NF) Level of Care (LOC).  The criteria that determines NF LOC is outlined in the Michigan Medicaid Nursing Facility Level of Care Determination (LOCD). 

The LOCD must be entered in The Community Health Automated Medicaid Processing System (CHAMPS) via MILogin according to Medicaid policy located in the Medicaid Provider Manual.  

The LOCD is to be completed by the nursing facility, MI Choice, PACE or MI Health Link provider prior to or on the day of admission or enrollment.  Medicaid services will not be reimbursed unless the beneficiary is determined functionally eligible through the web-based LOCD in CHAMPS.  The web-based LOCD must be entered in CHAMPS within 14 calendar days of the LOCD conducted date. 

 

LOCD Supplemental Information and Resources:

This is a button used to select LOCD Forms

This button is used to select LOCD Field Definition Guidelines

This button is used to select LOCD Freedom of Choice Form

 

This button is used to select LOCD Policy & Process Job Aids

This button is used to select Exception Criteria Information (Door 8)

This button is used to select Long Term Care Adverse Action Notices

 

 

This button is sued to obtain LOCD contact information.