NAC427A.456. Termination of services: Grounds; notification of recipient.

     1. In addition to any other requirements for closing a case and terminating the services of COPE set forth in NAC 427A.350 to 427A.488, inclusive, the Division will close a case and terminate services if:

     (a) The recipient dies.

     (b) The recipient fails to meet the criteria for eligibility listed in NAC 427A.402.

     (c) The recipient or his or her designated representative requests the discontinuation of the services.

     (d) The recipient fails to apply for, pursue or accept a claim for other benefits or fails to provide information essential to establish such a claim.

     (e) The recipient’s residence becomes unsafe for the recipient or his or her providers of service.

     (f) The recipient or his or her designated representative participates in any activity designed to defraud COPE or the Division.

     (g) The cost of services provided to the recipient is more than 100 percent of the average cost of care for a patient who receives care in a nursing facility.

     (h) The recipient fails to cooperate with the established plan of care.

     (i) Funds previously available have been expended.

     2. The Division may close a case if service becomes unavailable in the area where the recipient resides.

     3. Except in the case of the death of a recipient, the Division will notify a recipient or his or her designated representative, in writing, if the recipient’s case is being closed. The notice will be given at least 15 days before the services are to be terminated and will include:

     (a) The effective date the case is closed;

     (b) The reason or reasons for closing the case;

     (c) A statement of the rights of the recipient to an administrative review; and

     (d) The process for filing a request for an administrative review.

     (Added to NAC by Aging Services Div., eff. 7-16-92; A 1-10-97; R163-06, 9-18-2007; A by Aging & Disability Services Div. by R018-10, 7-22-2010)