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When the customer is in an acute care hospital during the month, the customer’s living arrangement immediately before entering the hospital is used to determine eligibility and share of cost.
For example, the customer was living in a nursing facility before entering the hospital. The time in the hospital is treated the same as living in the nursing facility. There is no change to the customer’s eligibility or share of cost.
Exception:
A customer in a long-term care bed in a hospital is considered to be living in a long-term care medical institution when determining eligibility and share of cost.
Term |
Definition |
Acute Hospital |
A medical institution licensed as a hospital by the Arizona Department of Health Services and certified as a provider under Title XVIII of the Social Security Act. |
Proof that a hospital is licensed and registered with AHCCCS is generally obtained through an electronic data match.
When proof is not available through this match or the facility is not listed in the electronic records, other sources of proof include:
Contact with the facility to determine:
· The name and address of the facility;
· Whether the facility is licensed or certified.
Program |
Legal Authorities |
ALTCS |
AAC R9-28-406(B) |