0815.000.00 Vendor Eligibility

0815.075.05 Claimant Moves to a Nursing Facility From Another Type of Vendor Facility

If entering a nursing facility, determine that the preadmission screening has been completed (see 0815.030.00 Vendor Surplus Computation):

  1. If the claimant is medically certified, make the appropriate change in IMU5
  2. If the claimant is not medically certified:
    • Send an IM-80 (Advance Notice of Adverse Action) advising the claimant that s/he is no longer eligible for vendor payments effective with the date s/he left the vendor facility.
    • Follow procedures in 0815.070.10 Vendor Facility to Private Home, Not Receiving HCB┬áto determine eligibility for Medical Assistance spenddown/non-spenddown coverage.