A participant stops attending, an authorization expires, or a center prepares to close. When does it belong on California's discharge report?
Quick answer: The CBAS Discharge Summary Report (CDA 4008) is California's cumulative calendar-year record of Medi-Cal participants discharged from Community-Based Adult Services centers. Centers record both Medi-Cal fee-for-service (FFS) and managed care discharges, but exclude private-pay participants. Submission depends on the circumstances, not a monthly deadline.
This guide explains the required fields, codes, submission rules, and a practical example.
What Is the CBAS Discharge Summary Report?
The California Department of Aging (CDA) uses CDA 4008 to track discharges from CBAS centers. It is a summary tracking document, not the participant's clinical discharge plan. Centers maintain the report cumulatively during each calendar year, adding a line when an applicable Medi-Cal participant is discharged.
Managed care discharges belong in the report even when they do not trigger immediate submission.
For program context, see Adult Day Genie's California CBAS software page.
Where Can Providers Find the Official CDA 4008 Form?
Download the CDA 4008 form and consult the separate CDA 4008i instructions through the CDA reporting requirements page.
The currently linked form's first page says revised February 2024, while the instructions say revised January 2022. The 2026 guide date does not indicate a new form. Check CDA for updates.
CDA 4008 Submission Requirements: When Must Centers Send It?
The CDA instructions identify three situations:
| Situation | What to do |
|---|---|
| A Medi-Cal FFS participant is discharged | Submit the cumulative report through the [Peach Provider Portal](https://peach.aging.ca.gov/) |
| The CBAS center closes | Submit the report through Peach |
| CDA requests the report | Follow the secure transmission instructions supplied by CDA |
Do not email the report as a routine submission. For CDA requests, use the specified secure method.
A discharge involving only a managed care participant belongs in the cumulative log, but is not by itself identified as the trigger for an immediate Peach submission under CDA 4008i. Check applicable managed care notification requirements separately.
Unlike the monthly MSSR, CDA 4008 has no blanket 10th-of-the-month submission date.
CDA 4008 Instructions: Complete Each Field
Begin with the center's legal name, National Provider Identifier (NPI), and the calendar year of the discharges. Complete one row for each reportable discharge.
| Column | Required information |
|---|---|
| A — Participant name | First and last name |
| B — CIN | Medi-Cal Client Identification Number |
| C — First date of attendance | First service date after the initial multidisciplinary-team assessment |
| D — Last date of attendance | Last date the participant attended before discharge |
| E — Date discharged | Actual discharge date under applicable reporting criteria |
| F — Reason | Select the applicable numbered discharge code |
| G — Payer | Medi-Cal managed care or Medi-Cal FFS |
| H — Comments | Relevant clarification, including the explanation for “Other” |
Use mm/dd/yyyy dates; last attendance and formal discharge can differ.
Before submission, the administrator or program director must sign and date the report. Check the participant's actual payer at discharge rather than copying a historical payer value.
CBAS Discharge Reason Codes Explained
The CDA form provides nine codes. Select the reason supported by the participant record:
- 1. Death — the participant died.
- 2. Nursing facility placement — the participant moved to a nursing facility.
- 3. Managed care plan/DHCS determined ineligible — the relevant payer or agency determined CBAS ineligibility.
- 4. Center closure; participant declined other services — the participant did not accept an alternative.
- 5. Center closure; CBAS center transfer — the participant transferred following closure.
- 6. Loss of Medi-Cal eligibility — qualifying Medi-Cal coverage ended.
- 7. Center discontinued services — discharge under center policies consistent with Title 22.
- 8. Participant discontinued services — the participant notified the center of their decision to stop.
- 9. Other — explain the reason in column H.
Choose codes based on documented events, not absence alone. Code 7 may apply to a participant who no longer benefits from CBAS or needs a higher level of care, subject to the center's compliant procedures.
Does the CBAS 60-Day Discharge Rule Mean Automatic Discharge?
No. The expression CBAS 60-day discharge rule is often oversimplified.
CDA 4008i says discharge information is reported for participants who were either discharged according to the center's policies and procedures or have not attended for 60 days AND have an expired authorization.
The word AND matters. Sixty days of absence alone does not establish that the second reporting condition has been met. A center can also have a documented discharge under its approved procedures before that point, subject to applicable requirements.
Review attendance, authorization, notices, and the discharge decision together. For the broader policy framework, see adult day care policies and procedures.
CDA 4008 Example: One Fictional Participant
Fictional example; never submit made-up identifiers.
| Field | Example entry |
|---|---|
| Participant | Jordan Example (fictional) |
| CIN | [Actual CIN from the secure participant file] |
| First attendance | 03/02/2026 |
| Last attendance | 08/18/2026 |
| Date discharged | 08/21/2026 |
| Discharge reason | Code 8 — Participant discontinued services |
| Payer | Medi-Cal fee-for-service |
| Comments | Participant requested termination; supporting documentation retained |
The participant requested termination; the center documented discharge on August 21, after last attendance.
Because the payer is Medi-Cal FFS, this discharge triggers submission of the cumulative CDA 4008 report through Peach. The program director must review, sign, and date it.
CDA 4008 vs. a Participant Discharge Plan
CDA 4008 is a tracking report: it lists discharged Medi-Cal participants, key dates, payers, and reasons. The discharge plan is an individual care record: it documents participant-specific arrangements and is kept in the participant's health record.
CDA instructions require discharge plans as part of the six-month reassessment and at discharge. Sending CDA 4008 does not replace preparing or retaining the underlying plan.
For organizing records, see Adult Day Genie's adult day care record retention requirements. Follow the retention and privacy obligations that apply to your program.
Common CDA 4008 Mistakes to Avoid
- Leaving out managed care discharges: Both managed care and FFS belong in the cumulative report.
- Including private-pay participants: CDA 4008i explicitly excludes them.
- Using the last attendance date as the discharge date without checking: These can be different events.
- Treating a 60-day absence as automatically sufficient: Check whether authorization also expired, or whether a discharge occurred under center policy.
- Sending identifiable information by ordinary email: Use Peach for the specified submissions or CDA's secure instructions when requested.
- Forgetting the required signature: Have the administrator or program director sign and date the report.
How Organized Participant Records Help
Discharge reporting becomes more difficult when attendance dates live in one spreadsheet, authorizations in another system, and completed forms are scattered across folders.
Adult Day Genie's daily operations software keeps participant information, attendance, care documentation, and reporting exports connected. This can help staff locate dates and supporting records before they manually complete an official report.
The software is not presented as automatically generating CDA 4008 or submitting it to Peach. Center staff must complete the form and follow CDA instructions.
Frequently Asked Questions
Does CDA 4008 include managed care participants?
Yes. Keep managed care and Medi-Cal FFS discharges in the cumulative annual report. A managed care discharge alone is not identified in CDA 4008i as the routine immediate Peach submission trigger.
Are private-pay participants included?
No. The official instructions expressly exclude private-pay participants from CDA 4008.
When must the CBAS Discharge Summary Report be submitted?
Submit via Peach upon a Medi-Cal FFS discharge or center closure. If CDA requests the report, follow the secure transmission instructions it provides.
Does 60 days without attendance automatically mean discharge?
No. CDA also identifies the combination of 60 days without attendance and an expired authorization, or a discharge completed under the center's compliant policies.
Is CDA 4008 the participant's discharge plan?
No. CDA 4008 is a tracking report. The individual discharge plan remains in the participant's health record and is subject to separate requirements.
Keep Discharge Records Ready
An accurate CBAS Discharge Summary Report begins with reliable participant identifiers, attendance dates, payer details, documented discharge reasons, and a clear decision trail. Connected records help staff prepare without changing legal obligations.
Want to see what that recordkeeping workflow looks like? Book an Adult Day Genie demo to explore participant records, attendance history, forms, and exports.
Editorial note: Based on CDA 4008 (first-page revision 02/2024), CDA 4008i (revision 01/2022), and current CDA reporting guidance reviewed October 12, 2026. This article is educational and does not replace official instructions, managed care plan requirements, or legal advice.