Critter Corner: The CCC Program When You’re Already in a Nursing Home

Dear Angel,

My mother received a letter in the mail about the mandatory Commonwealth Coordinated Care Plus (CCC Plus) Medicaid Managed Care Program. However, she is in a nursing home. Can she remain living at her current nursing facility, and what if anything will change?

Al Reddy-Thayer

Dear Al,

Commonwealth Coordinated Care Plus (CCC Plus) is a new Medicaid program that provides medical, behavioral, substance use disorder, and long-term services and supports all under one program. Medicaid individuals who meet CCC Plus participation criteria are required to participate.

If your mother resides in a nursing facility at the time of her CCC Plus enrollment, she may remain in her nursing facility for as long as she continues to meet the Medicaid level of care requirements for nursing home care. Even if her nursing facility does not contract with her health plan, she can remain in her nursing facility. In fact, efforts will be made to assign her to a health plan that contracts with the nursing facility where she lives.

If Medicaid determines that she continues to need nursing home level of care, she also has the option of choosing a different nursing facility or returning to the community with some services in place to help her. Her Care Coordinator should work together with the staff members of the nursing facility to develop her plan of care, monitor the care she receives, and help with discharge planning, if applicable.

If you or your mother would like help from a CCC Plus Advocate in making a decision about CCC Plus options or in resolving problems about plan benefits, she or you can call the Department of Aging and Rehabilitative Services, Office of the State Long-Term Care Ombudsman, at 1-800-552-5019.

Hope this is helpful!

Purrs and hugs,

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