Basic Considerations

Once LOS is met, the Medicaid CAP is used to determine financial eligibility for each month the A/R resides in a Medicaid participating hospital or nursing home, or for each month the A/R receives either hospice services from an approved provider or a NOW/COMP, ICWP or EDWP waivered service. If income exceeds the Medicaid CAP, refer to 2407 Qualified Income Trust .

The LOS requirement is not applicable to individuals already receiving Medicaid at the time of admission to one of the institutions or programs listed above.

Individuals receiving only Q Track COAs who enter one of these institutions or programs must meet the LOS requirement in order for the COA to be changed. LOS may be assumed where permissible. Refer to Chart 2235.1, Computing Length of Stay .

The LOS requirement is waived for individuals who die while residing in Living Arrangement D (LA-D). Refer to PROCEDURES in this section for a list of LA-D situations.

The LOS requirement can be assumed to have been met before 30 continuous days of confinement has elapsed in certain situations. Refer to Chart 2235.1, Computing Length of Stay .