Long-Term Care Documents for Employees
Policy & Procedure Manual
Action Notices & Benefit Determinations
Adequate Action Capacity Notice
Adequate Action Notice - NFLOCD (new)
Advance Action Notice - NFLOCD (existing participants)
Adverse Benefit Determination - Sample
Completing an Adverse Benefit Determination
MDHHS Action Notice Decision Guide (2023)
Request for Hearing for Medicaid Enrollees,Pace Enrollees or Waiver Applicants
Care Management Documents
Cognition/Mini Mental Exams
Flow Charts & Checklists
Checklists
Checklist for Changes to Participants PCSP
Checklist for Initial Assessment
Checklist for New Care Management Participants
Checklist for New MI Choice Participants
Checklist for Nursing Home Admission
Checklist for Participant Hospitalization
Checklist for Participant Re-Assessments & PCSP Review
Flow Charts
Forms & Letters
Fillable Forms
Food as Medicine Participant Consent Form
Food As Medicine Referral Form
Home Repair/Modification - Provider Bid Form
Home Repaire/Modification - Request Form
Informed Risk Agreement - SAMPLE
Non-Emergency Medical Transportation (NEMT) Form
Non-Recurrent Provider/Direct Service Purchase Agreement
Letters
HIPAA & Fraud, Waste, and Abuse
Policies
Forms
Guides
Initial Assessment
Participant Folder:
MI Choice Waiver Participant Handbook
Participant Fraud Waste & Abuse Information
Person Centered Planning Letter
Preventative Health Infographic
PRIVACY NOTICE For Medicaid and Other Medical Assistance Programs Effective December 1 2018
Self Determination Information Letter - template fillable
Initial Assessment Documents
Combined Text & Email Consent Form
COMPASS MI Choice Assessment - Participant Demographic Information
COMPASS MI Choice Assessment - Full Assessment
Post Assessment Referral Letter
Post Assessment Participant Letter
UPCAP Consent and Authorization
Wellsky Registration - Caregiver
Medicaid and MI Choice Enrollment
Medicaid
Mi Choice Enrollment & Disenrollment
New Employees/New Hires
Process Guides, Desk Aides & Supports Coordinator Resources
Assessments
Participant Falls & Injury Resources
Aging In Place Toolkit - CAPABLE
STEADI Brochures & Fact Sheets
Participant Nutrition Resources
Resources for Participants
Consumer-Info-Sheet-Cancer_8.5.21
Consumer-Info-Sheet-COPD_8.5.21
Consumer-Info-Sheet-Geriatrics-8.5.21
LR 8202 Age UK Malnutrition TF - Eating well in later life booklet A5
The_Ten_Ways_to_Improve_Your_Heart_Health
TipsForChewingAndSwallowingProblems
TipSheet_21_HealthyEatingForOlderAdults
Resources for Staff Providers
Participant Sleep Resources
More Guides/Miscellaneous
Participant Resources
Critical Incidents
Monitoring Contacts
Medication Lists
MLTSS 5 - Performance Measure for Falls
S.M.A.R.T. Goals
Staffing/Organizational Charts
Waiver Applications, Federal Requirements, MI Choice Contracts and Provider Manuals
Clinical Quality Assurance Review Audits
Referrals and Scheduling Initial Assessments
Self-Determination
Self-Determination Information/Resources
Fiscal Intermediary vs Agency with Choice
Hiring and Managing Personal Assistants
Person-Centered Planning Pre-Plan Questionnaire
Person-Centered Planning Relationship Map
Self-Determination Background Check Guide
Self-Determination Enrollment Form
Self-Determination in Long Term Care - Informational Handout
GT Financial
Northern Home Care Services
UPHP
Care Manager Contact List (June 2025)
Community Transition Assessment
Consent Form - Use for Medicaid Recertifications
MI Health Link Minimum Operating Standards
MI Health Link HCBS Waiver Application & Consent/Eligibility Certification Form
NFLOCD Tool Guidance and Checklist
Personal Care Assessment (PCA)
UPHP Document Type/Description Guide