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 Section 0815.030.00.)

  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 Section 0815.070.10 Vendor Facility to Private Home, not receiving HCB to determine eligibility for Medical Assistance spenddown/non-spenddown coverage.