Okla. Admin. Code § 317:35-19-5 - Application for nursing facility care; forms
(a)
Application procedures for nursing
facility care. An application for Nursing Facility (NF) level of care
consists of the Medical Assistance Application form. The form is signed by the
client, parent, spouse, guardian or someone else acting on the client's behalf.
(1) All conditions of eligibility must be
verified and documented in the case record. When current information already
available in the local office establishes eligibility, such information may be
used by recording source and date of information.
(2) At the request of an individual in an NF
or the community spouse, if application for Medicaid is not being made, an
assessment of the resources available to each spouse is made by use of DHS form
MA-11, Assessment of Assets. Documentation of resources must be provided by the
individual and/or spouse. This assessment reflects all countable resources of
the couple (owned individually or as a couple) and establishes the spousal
share to be protected when subsequent determination of Medicaid eligibility is
made. A copy of Form MA-11 is provided to each spouse for planning in regard to
future eligibility. A copy is retained in the county office in case of
subsequent application.
(3) If
assessment by Form MA-11 was not done at the time of entry into the nursing
home, assessment by use of Form MA-11 must be done at the time of application
for Medicaid. The spousal share of resources is determined for the month of
entry into the nursing home. If the individual applies for Medicaid at the time
of entry into the nursing home, Form MA-11 is not appropriate. However, the
spousal share must be determined using the resource information provided on the
Medicaid application form and computed using Form MA-12, Title XIX
Worksheet.
(b)
Date of application. When application is made in the county
office, the date of application is the date the applicant or someone acting on
his/her behalf signs the application form. When the application is initiated
outside the county office, the date of application is the date the application
is stamped into the county office. When a request for Medicaid services is
first made by an oral request and the application form is signed later, the
date of the oral request is entered in "red" above the date the form is signed.
The date of the oral request is the date of application. An exception is when
DHS has contracts with certain providers to take applications and obtain
documentation. After the documentation is obtained, the application and
documentation are forwarded to the DHS county office of the client's county of
residence for Medicaid eligibility determination. Under this circumstance, the
application date is the date the client signed the application form for the
provider.
Notes
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