Long-Term Care for Providers | Department of Human Services | Commonwealth of Pennsylvania

Long-Term Care for Providers | Department of Human Services | Commonwealth of Pennsylvania
​Long-Term Care Providers
2024 Home and Community-Based Rate and Wage Study
View the 2024 HCBS Rate and Wage Study
The Department of Human Services (DHS) released reports on the results of a rate and wage study for its long-term services and supports (LTSS) home and community-based services (HCBS) program.
HCBS are offered through Medicaid as an alternative to facility or institutional care. Reimbursement rates for these programs are set by DHS and are informed by an actuarial rate setting process and a public comment process. LTSS help older Pennsylvanians and adults with physical disabilities.
The study assesses rates paid to LTSS providers for the following services (see below), and the findings are used to inform the Commonwealth’s budget and future rate setting processes.
Adult day programs
Structured day habilitation
Employment and training
Residential habilitation
Personal assistance (offered through a home care agency)
Personal assistance (participant-directed services)
Additional information about the study:
Re-Opening of HCBS Rate and Wage Study Survey — Due November 15, 2024
Listserv Message dated October 1, 2024
OLTL HCBS Rate Study — Survey Questions
Rate and Wage Study Overview — June 5, 2024
Rate and Wage Study Updates — July 2, 2024
Rate and Wage Study Updates — Sept. 4, 2024
Home and Community-Based Services (HCBS) Quality Improvement Funding Opportunity
HCBS Quality Improvement Funding Round Two — Due November 30, 2024
Agency with Choice-Public Input
Public Comments on Agency with Choice RFI - Updated April 21, 2022
American Rescue Plan Act (ARPA) Funding
Summary of American Rescue Plan Act (ARPA) Funding
American Rescue Plan Act (ARPA) Funding Reporting Portal
American Rescue Plan Act (ARPA) Funding Reporting Portal FAQ
Act 54
Act 54 Reporting Webinar – July 17, 2024
Transcript
Nursing Facility Ventilator/Tracheostomy (Vent-Trach) Provider Payment ($4,283,000)
Personal Care Home (PCH) and Assisted Living Residences (ALR) ($26,767,000)
Agency Personal Assistance Provider Payment ($59,957,000)
Adult Daily Living Provider Payment ($6,959,000)
Residential Habilitation Provider Payment ($535,000)
LIFE Provider Payment ($5,353,000)
Nursing Facility Medicaid Days Payment ($104,926,000) - Updated October 14, 2022
Nursing Facility Licensed Bed Payment ($26,231,000)
Act 54 Funding Distribution
American Rescue Plan Act (ARPA) Act 54 Payments - Notification, Instructions, and Timelines for Personal Care Homes (PCH) and Assisted Living Residences (ALR)
American Rescue Plan Act (ARPA) Act 54 Payments - Notification, Instructions, Timelines for Nursing Facilities (NF) Not Enrolled in the Medical Assistance (MA) Program
Act 54 Payment Letter to Nursing Facility Providers
Act 54 Payment Letter to Home and Community-Based Services (HCBS) and Living Independence for the Elderly (LIFE) Providers
Act 54 Payment Letter to Personal Care Home (PCH) and Assisted Living Residence (ALR) Providers
Strengthening the Workforce
Strengthening the Workforce and Adult Day Services (ADS) Payment Frequently Asked Questions (FAQ) - Updated February 15, 2022
Strengthening the Workforce Letter to Home and Community-Based Services (HCBS) Providers
Strengthening the Workforce Letter to Adult Day Services (ADS) Providers
Office of Long-Term Living (OLTL) Provider Attestation form for Home and Community-Based Services (HCBS) Providers
Office of Long-Term Living (OLTL) Provider Attestation form for Adult Day Services (ADS) Providers
Strengthening the Workforce Payments to Personal Assistance Services (PAS) Providers
Strengthening the Workforce Payments to Residential Habilitation (Res Hab) Providers
Strengthening the Workforce Payments to Adult Day Services (ADS) Providers
Strengthening the Workforce Payments Communication
Direct Care Workers Through Public Partnerships, LLC (PPL)
Questions and Answers on Rate Increase
Direct Care Worker Billable and Pay Rate Update
How to Determine Direct Care Worker's Maximum Wage
Act 24
Nursing Facility Payment 1 ($198,000,000)
Nursing Facility Payment 2 ($49,000,000)
Personal Care Home (PCH) and Assisted Living Residence (ALR) Payment 1 ($27,000,000)
Personal Care Home (PCH) and Assisted Living Residence (ALR) Payment 2 ($3,000,000)
Facility Acceptance Forms Received by DHS
Facility Acceptance Form
ARPA Payment Letter to Providers
ARPA Funding Distribution
Indoor Air Management Strategies Grant Program - Request for Applications (eMarketplace)
Indoor Air Management Approved Grants - Week 1
Indoor Air Management Approved Grants - Week 2
Indoor Air Management Approved Grants - Week 3
Indoor Air management Approved Grants - Week 4
Indoor Air Management Approved Grants - Week 5
Indoor Air Management Approved Grants - Week 6
Indoor Air Management Approved Grants - Week 7
Indoor Air Management Approved Grants - Week 8
Indoor Air Management Approced Grants - Week 9
Indoor Air Management Approved Grants - Week 10 & 11
Indoor Air Management Approved Grants - Week 12 & 13
Indoor Air Management Approved Grants - Week 14
CARES Act Cost Report Forms
COVID-19 Personal Care Home (PCH) Act 24 Cost Reporting Form
COVID-19 Non Public Nursing Facility (NF) Act 24 Cost Reporting Form
COVID-19 Agency Personal Assistance Services (PAS) and Home Health Agency (HHA) Act 24 Cost Reporting Form
COVID-19 Adult Day Care Act 24 Cost Reporting Form
COVID-19 Licensed Residential Habilitation (Res Hab) Act 24 Cost Reporting Form
CARES Act Payments
Adult Day Services (ADS) Payment ($13,000,000)
Home Health Care and Home Care Agency Personal Assistance Services (PAS) Payment ($112,000,000)
Nursing Facility Payment 1 ($196,000,000)
Nursing Facility Payment 2 ($49,000,000)
Personal Care Home (PCH) and Assisted Living Residences (ALR)
Payment ($45,000,000)
PCH Payment ($5,000,000)
Living Independence for the Elderly (LIFE) Payment ($10,000,000)
Community HealthChoices (CHC) Managed Care Organizations (MCO) Payment ($50,000,000)
Residential Habilitation (Res-Hab) Payment ($1,000,000)
Ventilator or Tracheostomy (Vent-Trach) Care Payment ($8,000,000)
Act 24 Non-MA Provider Payment Status
CARES Act Additional Resources
Act 24 COVID-19 Nursing Facility Cost Reporting Presentation (11/16/20)
Act 24 COVID-19 Nursing Facility Cost Reporting Presentation Slides (11/16/20)
Act 24 COVID-19 Non-Nursing Facility Cost Reporting Presentation (11/20/20)
Act 24 COVID-19 Non-Nursing Facility Cost Reporting Presentation Slides (11/20/20)
Act 24 COVID-19 Non-Nursing Facility Cost Reporting Presentation (12/1/20)
Act 24 COVID-19 Non-Nursing Facility Cost Reporting Presentation Slides (12/1/20)
Abuse, Neglect, Abandonment, and Financial Exploitation
Ensuring the health and safety of program participants is one of the waiver assurances required by the Centers for Medicare and Medicaid Services. Additionally, state laws are in place requiring service coordinators and direct service providers to report abuse, neglect, abandonment and financial exploitation. Office of Long-Term Living (OLTL) service coordinators and direct service providers are mandatory reporters under the law.
Adult Protective Services
To report the need for protective services, call the 24-hour statewide Protective Services Hotline at 1-800-490-8505
In 2010, the Adult Protective Services Law, Act 70 of 2010, was enacted to provide protective services to adults between 18 and 59 years of age who have a physical or mental impairment that substantially limits one or more major life activities. The law establishes a program of protective services in order to detect, prevent, reduce and eliminate abuse, neglect, exploitation, and abandonment of adults in need. Learn more about
Adult Protective Services
.
Older Adults Protective Services
Statewide Elder Abuse Hotline: 1-800-490-8505
The
Department of Aging
is responsible for oversight and implementation of the
Older Adults Protective Services Act
for individuals over the age of 60.
Waiver Participant Informational Materials
In order to ensure consistent information throughout each county, OLTL requires all Service Coordination agencies to provide standardized materials to all waiver participants. These
materials
have been translated from English into the following languages: Chinese (Simplified), Khmer (Cambodian), Russian, Spanish, and Vietnamese.
View corresponding bulletins relating to this material
.
OLTL HCBS Provider Handbook
The
Provider Handbook
outlines applicable programs, policies, and procedures for all providers serving participants in OLTL HCBS Programs.
View
copies of appendix forms
.
Financial Management Services
Financial Management Services are available to participants who receive participant-directed services in the Community HealthChoices (CHC) and Omnibus Budget Reconciliation Act (OBRA) waivers or the Act 150 program. For participants that choose to direct their services, a Vendor Fiscal Employer Agent (VF/EA) organization acts as the employer agent on behalf of the participant. The fiscal support services include administrative payroll functions such as the management of federal and state income tax withholding and employment taxes and locality taxes, processing direct care worker timesheets, brokering worker's compensation insurance policies, and preparing and distributing financial reports.
In-Person Drop-In Sessions
In-Person Drop-In Sessions for Participants in Commuity HealthChoices (CHC)Participant-Directed Services
Financial Management Services (FMS) Stakeholder Meeting Materials
FMS Transition Stakeholder Meeting Agenda 9.3.21
FMS Transition Stakeholder Meeting Tempus Presentation 9.3.21
FMS Transition Stakeholder Meeting Agenda 10.1.21
FMS Transition Stakeholder Meeting Tempus Presentation 10.1.21
FMS Transition Stakeholder Meeting Agenda 12.3.21
FMS Transition Stakeholder Meeting Tempus Presentation 12.3.21
FMS Transition Stakeholder Meeting Agenda 1.7.22
FMS Transition Stakeholder Meeting Tempus Presentation 1.7.22
FMS Transition Stakeholder Meeting Agenda 2.4.22
FMS Transition Stakeholder Meeting Tempus Presentation 2.4.22
FMS Transition Stakeholder Meeting Tempus Agenda 2.18.22
FMS Transition Stakeholder Meeting Tempus Presentation 2.18.22
FMS Transition Stakeholder Meeting Q&A 2.18.22
FMS Transition Stakeholder Meeting Tempus Agenda 3.4.22
FMS Transition Stakeholder Meeting Tempus Presentation 3.4.22
FMS Transition Stakeholder Meeting Q&A 3.4.22
FMS Transition Stakeholder Meeting Agenda 4.1.22
FMS Transition Stakeholder Meeting Tempus Presentation 4.1.22
FMS Transition Stakeholder Meeting Q&A 4.1.22
FMS Transiion Stakeholder Meeting Agenda 5.6.22
FMS Transition Stakeholder Meeting Tempus Presentation 5.6.22
(Slides)
FMS Transition Stakeholder Meeting Tempus Presentation 5.6.22
(Webinar)
FMS Transition Stakeholder Meeting Q&A 5.6.22
FMS Transition Stakeholder Meeting Agenda 6.3.22
FMS Transition Stakeholder Meeting Tempus Presentation 6.3.22 (Slides)
FMS Transition Stakeholder Meeting Q&A 6.3.22
FMS Transition Stakeholder Meeting Agenda 6.17.22
FMS Transition Stakeholder Meeting Tempus Presentation 6.17.22 (Slides)
FMS Transition Stakeholder Meeting Q&A 6.17.22
FMS Transition Stakeholder Meeting Agenda 7.1.22
FMS Transition Stakeholder Meeting Tempus Presentation 7.1.22 (Slides)
FMS Transition Stakeholder Meeting Q&A 7.1.22
FMS Transition Stakeholder Meeting Agenda 8.5.22
FMS Transition Stakeholder Meeting Tempus Presentation 8.5.22 (Slides)
FMS Transition Stakeholder Meeting Q&A 8.5.22
FMS Transition Stakeholder Meeting Agenda 9.2.22
FMS Transition Stakeholder Meeting Tempus Presentation 9.2.22 (Slides)
FMS Transition Stakeholder Meeting Q&A 9.2.22
FMS Transition Stakeholder Meeting Agenda 10.7.22
FMS Transition Stakeholder Meeting Tempus Presentation 10.7.22 (Slides)
FMS Transition Stakeholder Meeting Q&A 10.7.22
FMS Transition Stakeholder Meeting Tempus Presentation 1.6.23 (Slides)
FMS Transition Stakeholder Meeting Q&A 1.6.23
FMS Regions and Rates
FMS Sample Forms
CLE Agreement Form
CLE Participant Change Form
DCW Qualification Form
DCW Termination Form
Designated Representative Form
Good to Go Process
DCW Timesheet
DCW Agreement
Letters from MCOs regarding the FMS transition can be found
here
in the Documentation section of the page.
Direct Care Worker Unique ID
Service Coordination Afterhours Phone Numbers
Long-Term Care Nursing Facility Providers
Long Term Living Training Institute
Domiciliary Care
Domiciliary Care FAQ
HCBS Waiver Provider Agreement
HCBS Waiver Revalidation Information
Revalidation FAQs
OLTL Training and Technical Assistance
Needs Assessment
Needs Assessment Instructions
Notice of Service determination and the RIGHT to Appeal (MA561)
Nursing Home Transition Program Overview
Office of Medical Assistance Programs Provider Bulletins
Order Medical Assistance Forms
PROMISe Provider Enrollment Base Application CHECKLIST
Quality
Self-Direction
Services My Way Program Information
OLTL Home HCBS Regulations and Rates
On May 19, 2012, the Long-Term Living Home and Community-Based Service Regulation went into effect. The following documents contain the regulation as it appears in the Pennsylvania Bulletin and instructions on billing for services. The OLTL Billing Instructions Bulletin contains information on quarter-hour unit billing, billable and non-billable activities for service coordinators, and
new rates
.
MA Fee Schedule Rates
OLTL HCBS Rates January 1, 2026
OLTL HCBS Rates January 1, 2025
OLTL HCBS Rates January 1, 2022
OLTL HCBS Rates May 26, 2020
OLTL HCBS Rates January 1, 2020
OLTL HCBS Rates July 1, 2018
OLTL HCBS Rates October 1, 2017
OLTL HCBS Rates December 1, 2016
OLTL HCBS Rates November 19, 2016
OLTL HCBS Rates January 1, 2016
OLTL HCBS Rates October 28, 2015
OLTL HCBS Rates July 1, 2014
OLTL HCBS Rates January 26, 2013
OLTL HCBS Rates June 1, 2012
OLTL Fee Schedule Rates-Regions
OLTL MA Rate Notices
February 28, 2026 (PAS Consumer-Directed)
November 6, 2021 (ACT 150 and OBRA Rates)
August 24, 2019 (OBRA Rates)
November 30, 2019 (ACT 150 Rates)
Nov. 19, 2016 (Employment Rates)
Jan. 1, 2016 Rate Notice (Overtime)
Oct. 28, 2015 Rate Notice (Waiver Changes)
Sept. 13, 2014 Rate Notices (Service Coordination)
Sept. 13, 2014 Rate Notices (PAS Consumer-Directed)
Sept. 13, 2014 Rate Notices (PAS Agency)
Jan. 26, 2013 Rate Notice (Service Coordination)
Jan. 26, 2013 Rate Notice (Enrollment)
July 14, 2012 Service Coordination • Rate Notice
June 30, 2012 Aging Waiver Enrollment
Fee Rate Notice
June 9, 2012 Rate Notice
Billing Rates
OLTL Billing Instructions Bulletin
Attachment A
Attachment B
Rate Regions
Service Coordination: HCSIS Information
E-mail
Service Plan Instructions
Service Coordination: FAQ
FAQ 02/2014
Conflict-Free Service Coordination
E-mail
Explanation
Conflict-Free Choice Form
HCBS Regulation: FAQ
FAQs (updated as of 06/17/2013)
Strengthening the Workforce Payment FAQs 2.15.22.pdf
Training & Technical Assistance
Critical Incident Management Training: Incident Reporting
Service Plan Assurances and Performance Measures Training March 2015 (PowerPoint)
Risk Mitigation Webinar
Risk Mitigation PowerPoint
Employment and Employment Related Services Webinar (8/23/16
Employment Webinar (11/2016)
Employment Webinar FAQ (11/2016)
Related material:
PPL Contract Summary as Posted to PA Treasury Website
Public Partnerships' Web Portal Instruction Guide for Service Coordinators
FMS FAQ #1 for Service Coordinators 9/27/2012
FMS FAQ #2 for Service Coordinators 9/27/2012
FMS FAQ #3 for Service Coordinators
FMS FAQ #4 for Service Coordinators
Existing EIN Took Kit
New Participant FMS Referral Form w-Options