Community Case Management

Community Case Management (CCM) is part of MassHealth, It is for Masshealth members under 22 (although services do not discontinue when a child turns 22) who require continuous nursing.

Services include:

  • a comprehensive needs assessment performed by a pediatric nurse case manager
  • An in-person visit with the member
  • A member-focus, clinically appropriate service plan
  • A single point to access community long term care services: nursing, home health aide, personal care attendant, physical, occupational and speech and hearing therapy, durable medical equipment, and oxygen and respiratory equipment
  • An expedited service authorization plan
  • Case manager participation in hospital and institutional discharge planning meetings.
  • Insurance identification and referrals
  • Case collaboration with other care providers, as appropriate

For more info about CCM call 800 863-6068. A referral can be made by anyone. The criteria after being a Masshealth member is that the person requires 2 or more hours of consecutive nursing care a day. The nurse case manager goes to the home and completes with the caregiver a very extensive intake/assessment.

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