If a participant age 22 to 65 leaves the vendor facility and enters the State Hospital (General Medical and Surgical or Psychiatric Sections):
- Record the information at the Eligibility Unit Member Role/EUMEMROL/FM3Z screen in FAMIS.
- Contact the resource investigator at the facility to establish:
- anticipated length of stay and/or possible date of release
- plans for placement and/or living arrangements upon release
- If plans have been made for the participant’s release:
- set a priority to follow up on the participant’s planned date of release
- take necessary action, based on the participant’s living arrangements at the time of release from the State Hospital.
- If no plans have been made for the claimant’s release, set a priority to follow up in 21 days.
- If participant is still residing in the facility and no plans have been made for his/her release, change the claimant’s level of care to T (Title XIX only).
- Send the participant , legal guardian or relative, and the nursing facility, the notification letter of action taken (IM-33). Advise the claimant that s/he is ineligible for vendor payments.
- Complete an MA determination as if the participant were in his/her own home.