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US · guidance

CMS Pub. 100-11, ch. 15, § 60.3

Annual Monitoring

activein force · 2026-08-25 – presentas-observed

The State Administering Agency assures that at least annually it will reevaluate whether a

participant meets the level of care required under the State Medicaid plan for coverage of

nursing facility services. The State Administering Agency understands that this

determination may be waived if there is no reasonable expectation of improvement or

significant change in the participant’s conditions because of the severity of a chronic

condition or the degree of impairment of functional capacity. The State Administering

Agency assures that it will make reviews conducted in accordance with 42 CFR §§

460.190 and 460.192 available to the public upon request.

[42 CFR §§ 460.160(b)(a), 460.196(b)]

History

(Rev. 2, Issued: 06-09-11; Effective: 06-03-11; Implementation: 06-03-11)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
5ea27809e1ceb661ce00b410ffdda9be3ee5c58f3679c5aa3d894b83aa42169c
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