As a result of the recent assessment, Senior Health Partners has made an updated decision about the service we can provide to you. This letter is to notify you that Senior Health Partners has determined that the requested service will be reduced, effective 09/28/2015
The reason for our decision is: The requested service is not medically necessary at the present time.
After a review of all information, including the most current assessment, as outlined below, Healthfirst is changing the services you currently receive. We are approving a total of 63 hours per week for personal care assistance support.
This is both a reassessment of your current personal care assistance services and in response to a request for additional personal care assistance services from you. At this time you have 56 hours of Personal Care Assistant Services per week. We reviewed the recent evaluation done in your home in June 2015. This assessment identified that you required 44 hours of Personal Care Assistant Services for direct …show more content…
We have also added 3 hours to assist with completing meal preparation and cleanup. We are approving a total of 63 hours per week for personal care assistance support.
The additional time being requested is for safety supervision without the direct provision of activity of daily living task support. Safety supervision is covered as part of the total personal care service hours authorized if observed during the delivery of identified personal care services, such as bathing. However, in accordance with NYS administrative directive GIS 03 MA/003, safety supervision is not covered as a separate or a stand-alone function. We cannot approve additional hours for safety supervision.
You live with your parent, who is willing to provide
The reason for our decision is: The requested service is not medically necessary at the present time.
After a review of all information, including the most current assessment, as outlined below, Healthfirst is changing the services you currently receive. We are approving a total of 63 hours per week for personal care assistance support.
This is both a reassessment of your current personal care assistance services and in response to a request for additional personal care assistance services from you. At this time you have 56 hours of Personal Care Assistant Services per week. We reviewed the recent evaluation done in your home in June 2015. This assessment identified that you required 44 hours of Personal Care Assistant Services for direct …show more content…
We have also added 3 hours to assist with completing meal preparation and cleanup. We are approving a total of 63 hours per week for personal care assistance support.
The additional time being requested is for safety supervision without the direct provision of activity of daily living task support. Safety supervision is covered as part of the total personal care service hours authorized if observed during the delivery of identified personal care services, such as bathing. However, in accordance with NYS administrative directive GIS 03 MA/003, safety supervision is not covered as a separate or a stand-alone function. We cannot approve additional hours for safety supervision.
You live with your parent, who is willing to provide