P    Long Term Care Living Arrangement

Policy

Changes in a customer’s long term care living arrangement, including admission to or discharge from a nursing facility or public institution must be reported.

For a customer who receives services under ALTCS or Freedom to Work (FTW) – ALTCS programs, living arrangement changes may affect the customer’s services, Share of Cost (SOC), or premium. See MA521 for detailed policy on living arrangements.

For a Veteran customer, a change in living arrangement may affect:

·        Eligibility for VA potential benefits for the customer or applying spouse or dependent; or

·        The maximum potential VA income benefit.

See Living Arrangement Changes Examples.

Use the following manual sections for policy related to other living arrangement changes:

Proof

When the customer reports a new living arrangement the following information is needed:

·        Date the customer entered the new living arrangement;

·        Type of facility, when customer is residing in a medical or home and community-based setting (HCBS) facility; and

·        Date the customer left the previous living arrangement.

Programs Affected

This applies to the following programs:

·        ALTCS

·        FTW-ALTCS

Timeframes

When the customer moves from a setting in which only limited ALTCS services can be provided to a setting where full long term care services can be provided, the customer is eligible for full long term care services beginning on the date that they moved to a setting where long term care services can be provided, rather than the first of the month.

Legal Authority