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Medical Services – Glossary

MS Manual 09/01/26

Patient Liability – The amount a recipient residing in a facility is responsible for paying the provider for services. Permanently Institutionalized – When a medical determination is made which indicates there is no reasonable expectation that the individual is likely to return home. The date on which an individual was determined to be permanently institutionalized is irrelevant. If services were provided prior to the time a decision was made regarding permanent institutionalization, recovery will include assistance provided prior to the decision. Personal Needs Allowance – An amount allowed the Nursing Facility recipient to cover the cost of personal items not covered by the facility fee. Personal Representative – The executor of a will or administrator of an estate who has been appointed to the position by a probate court. Plan of Care (POC) – A document utilized by a provider to plan, direct or deliver care to a patient to meet specific measurable goals. Protected Maintenance Allowance – An amount given by the institutionalized spouse (IS) to the dependent child(ren) living in the home when the IS does not have a community spouse (CS). Provider – A person, organization or institution enrolled to provide and be reimbursed for health or medical care services authorized under State Title XIX Medicaid Program. Provisional Plan of Care – Based on the assessment, the individual has met functional/medical criteria, but financial eligibility has not yet been determined. The client and the provider assume the responsibility of liability should the client not meet all criteria for eligibility and services begin. The provisional

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