To be eligible for Intermediate or Skilled SNC, in addition to meeting the December 1973 eligibility requirements, the participant must be certified as medically in need of the Intermediate or Skilled level of nursing facility (NF) care.
The eligibility specialist is to do the following:
- Obtain medical information (DA-124).
- Submit the medical information, Initial Assessment form (DA-124), to the Department of Health and Senior Services, Division of Senior and Disability Services. (If the Initial Assessment does not sufficiently describe the participant’s ability to function, etc., attach a letter to the DA-124, providing observations). If the participant is medically certified, Department of Health and Senior Services, Division of Senior and Disability Services returns the Initial Assessment Report (DA-124), indicating the participant has been approved.
- File a copy of the Initial Assessment (DA-124) in the case record.
- Approve the participant for a cash grant, up to the maximum SNC payment for Intermediate or Skilled Nursing Care.
If Department of Health and Senior Services, Division of Senior and Disability Services returns the Initial Assessment and indicates the participant is NOT medically certified:
- file a copy of the Initial Assessment (DA-124) in the case record; and
- approve the participant for a cash grant, up to the maximum SNC payment for Assisted Living Facility (ALF) or Residential Care Facility (RCF).