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LCED Instructions Final 42911

Page 1 of 15 Instructions for the LCED Form Revised 01/28/2020 Instructions Instructions for the Completion of the Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) Level of Care Eligibility Determination (LCED) Form for Home and Community Based Services (HCBS) Waiver, Comprehensive Care Coordination and other State Plan Services Purpose: The following information is intended to provide guidance on the completion of the ICF/IID Level of Care Eligibility Determination (LCED) and LCED form. The LCED form is used for the initial determination and annual redetermination ( , re-evaluation) for individuals seeking to access or maintain Home and Community Based Services (HCBS) Waiver, Comprehensive Care Coordination and other State Plan services. This information includes the criteria for determining eligibility as well as the step-by-step Instructions for completing the LCED form. The criteria used are the same for the initial and annual redetermination reviews for HCBS Waiver, Comprehensive Care Coordination and other State Plan Services This guidance replaces the Instructions for the Completion of the ICF/MR Level of Care Eligibility Determination (LCED) Form for HCBS Waiver Participants (HCBS Form (5/2010, 4/2011)) revised 4/29/2011.

Page 1 of 15 Instructions for the LCED Form Revised 01/28/2020 ... eligibility as well as the step-by-step instructions for completing the LCED form. The criteria used ... The initial LCED must be reviewed, signed, and dated by a physician or nurse practitioner. The

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