Back to Insights and Updates for ProvidersSeptember 2025

Reminder for SNFs: Submit SC-1 forms to Tufts Health Plan and MassHealth

Tufts Health One Care  |  Tufts Health Plan Senior Care Options

As a reminder, skilled nursing facilities (SNFs) are required to submit a Status Change Form (SC-1) to MassHealth and Tufts Health Plan when a member of Tufts Health Plan Senior Care Options (SCO) or Tufts Health One Care is admitted for stays of two months or longer. Timely submission of this form helps ensure that claims process accurately.

The SC-1 form should be submitted to both the MassHealth Enrollment Center and Tufts Health Plan. This form is necessary upon admission for stays in which the member will be returning home as well as stays in which the SNF will be the member’s residence. The form is not required, however, for stays shorter than two months. Please follow the submission instructions below.

Type of stay When to submit How to submit

(Instructions below are for SC-1 form only. Refer to the Skilled Nursing Facility [SNF] Documentation Submission Guide for instructions on additional documentation.)
Skilled Care – fewer than 2 months SC-1 form is not needed. N/A
Custodial Care

(short-term/non-skilled stay; member will be returning home)

 Upon admission and discharge
  • MassHealth Enrollment Center AND
  • Tufts Health Plan as follows

For SCO: Fax to SCO Clinical Department at 617-673-0781

For One Care: Fax to 617-673-0926, Attn: Membership Accounting Department
Long-term Stay

(SNF will be member’s residence)

 Upon admission and when status changes (within 5 business days for status changes)
  • MassHealth Enrollment Center AND
  • Tufts Health Plan as follows

For SCO:

For One Care:

Reminders on claims payment

Submitting the SC-1 form to Tufts Health Plan does not guarantee claims payment. Please keep in mind as well that MassHealth must first update the member’s record in the Medicaid Management Information System (MMIS) before Tufts Health Plan can process the claims.

If there are delays in claim payment, please check the MMIS site to confirm whether the Minimum Data Set (MDS) Level of Care (LOC) is on file.

  • If the MDS LOC is not on file, please contact MassHealth directly to correct the issue.
  • If the MDS LOC is on file and claims are still delayed, email [email protected] for further assistance.

For additional details please refer to the Skilled Nursing Facility (SNF) Documentation Submission Guide, the Skilled Nursing Facility Payment Policies, and these MassHealth instructions.