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My friend is a Medi-Cal recipient residing in a nursing home. What is the facility’s obligation to make sure he gets to and from specialist medical appointments? 

Dear Advocate:

My friend is a Medi-Cal recipient residing in a nursing home. His specialist does not do nursing home visits so we must arrange for transportation to and from the appointments. What is the facility’s obligation to make sure he gets to and from these appointments?

Sincerely,

Stressed in Santa Barbara

Dear Stressed:

First and foremost, the facility is required to provide the necessary care and services to attain or maintain the highest practicable physical, mental and psychosocial well-being (42 USC §1396r(b)(2); 42 USC §1395i-3(b)(2); 42 CFR §483.24; 22 CCR §72315).

This includes arranging for transportation to a specialist if it is necessary to maintain his wellbeing. Since your friend is a Medi-Cal recipient, Medi-Cal will pay for transportation to and from appointments that are medically necessary, but it is ultimately the facility’s job to arrange for transportation.

If the facility is unable to find resources available to the resident for transportation, the facility must find and arrange for other means of transportation.