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 & Discharge
Checklist for Participant Hospitalization
Checklist for Participant Re-Assessments
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
Quality Management Collaborative Brochure
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
UPHP Self-Determination Information for Participant
Waiver HCBS 90-Day Care Plan Review Tool - Script Example