tar dis ltc
1 TAR Discharge Planning Option for Long Term Care
This section gives instructions on how to complete an authorization request using the Long Term Care
Treatment Authorization Request (LTC TAR, 20-1).
Post-Discharge Nursing The Long Term Care Treatment Authorization Request (20-1)
Facility Services is used to request initial authorization for post-discharge Nursing
Facility (NF) services. The Medi-Cal consultant will write “DPT” in the
upper left corner of the 20-1 form and in the comments section to
differentiate the Discharge Planning TAR from a normal 20-1 TAR.
For an example of a correctly completed 20-1 for NF care, see
Figure 1 on a following page.
Note: If the patient needs post-discharge community services, the
discharge planner will fill out a Medi-Cal Managed Care
Authorization form (55-1) instead of a 20-1. Refer to the
TAR Discharge Planning Option section in this manual for
instructions on completing the 55-1.
Patients Discharged to If the patient is to be discharged to a NF, a 20-1 must be initiated a Nursing Facility by the acute care hospital discharge planner.
The 20-1 is then presented to the Medi-Cal consultant who will review
the medical record and, if appropriate, authorize the NF level of care.
The consultant will also review the PASRR Screening Document and
enter the following information in the Comments/Explanation section
of the 20-1:
; Date the PASRR Screening Document was completed and the
date of the referral to Level II, if appropriate
; Level of care authorized
; Indicate if a Medicare denial is needed
; Date and signature of Medi-Cal consultant
The Medi-Cal consultant has the authority to approve a stay of up to
one year in a NF. The consultant will make this determination based
on the patient’s chart and the results of the PASRR Screening
Instructions on how to complete the screening document are in the
Preadmission Screening Resident Review (PASRR) section in the
appropriate Part 2 manual.
A patient who is referred for Level II evaluation will only be approved
for a four-month maximum NF stay.
2 – TAR Discharge Planning Option for Long Term Care August 2002
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Where to Submit The NF is responsible for completing the 20-1 and forwarding it to the 20-1 TAR Form the San Bernardino Medi-Cal Field Office.
The 20-1 and PASRR Screening Document must accompany the
patient to the NF. If post-discharge community services have been
requested for the patient on a 55-1, and a post-discharge provider has
not been found prior to admission to the NF, the authorized 55-1 must
also accompany the patient to the NF. The NF is responsible for
locating a willing post-discharge community provider and giving the
provider the copy of the 55-1. The post-discharge provider completes
the 55-1 and submits it to the field office. In this case, all timeliness
guidelines have been met.
Medicare/Medi-Cal For Medicare/Medi-Cal crossover patients admitted to an NF under Crossover Patients Medicare reimbursement, a 20-1 must be initiated by the acute care
hospital, reviewed and authorized by the Medi-Cal consultant and
sent with the patient to the NF along with a copy of the PASRR
Screening Document. This allows NF providers to bill Medi-Cal as
soon as the patient's Medicare benefits have exhausted without
waiting for further TAR approval. In this case, NF providers must
include a copy of the Medicare denial when submitting the 20-1 to the
2 – TAR Discharge Planning Option for Long Term Care July 2002
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