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State of Maryland Medical Assistance Manual Revised April 2014

• Enter the appropriate valid value code “MD” (Mental Disease Facility) under “Living Arrgmt” on the “DEM1” screen for the new AU. • Evaluate countable assets to ascertain whether a disposal has taken place within the applicable look-back period. • Complete the “INST” screen, including: o Institution type: Use “ NH” (Nursing Home); o CARES Vendor ID (Prov ID); o Date of Admission (Entry Date); o Level of Care (Level Auth). Use “U” (Under 21 Psychiatric) for children under 21 years old or “L” (LTC Hospital) for adults aged 21 or older; and o Requested Begin-Pay Date (LTC Payment Auth Date). • After completing the Interview, go to “Done”. This will simultaneously close out the community AU and allow you to process the new LTC AU. • Process (“P”) and Finalize (“Q) the case. b) For a recipient who is in an existing community MA AU with other members receiving benefits (e.g., spouse, parents, children): • Select “J” (Screening) to rescreen the case. • Select “Long Term Care” from the “KIND” screen. • When you get to the “INCH” screen, “PF20” to find a match for the recipient. • Continue to follow the procedures outlined in a) above. The recipient must be entered as Head of household (“SE”). This will terminate the recipient’s eligibility in the community MA Case. • If a child is a member of an active TCA AU when institutionalized in an IMD, the child may remain in both the TCA AU and the MA- LTC AU. (Follow TCA policies that address when a child who is placed out-of-home must be removed from the TCA AU) • Eligibility must be redetermined for the remaining members of the MA Community AU.

2. For a recipient institutionalized in an IMD who is 21 years old: • If the recipient was admitted before age 21 and remains in the IMD for a continuous period of institutionalization, the recipient is covered by MA for IMD service until earlier of the date that the recipient: (a) is determined by the ASO to no longer need IMD services, (b) is unconditionally discharged from the IMD, (c) reaches age 22, or (d) loses MA eligibility for other reasons. • If the recipient is 21 years old when admitted or when an institutionalized person in an IMD reaches age 22, the procedures in #3 or #4below are followed. 3. Individuals between age 22 through 64 are not MA eligible if they are institutionalized in an IMD. Therefore, their MA eligibility must be cancelled with timely notice. The date that the individual is considered institutionalized is specified in Part IV of the DES 1000. The MA CM or financial agent uses the following CARES procedures to terminate MA eligibility: • Complete the unscheduled redetermination i.e. rescreen, etc. following the procedures given in #1b) above. The person must be entered as Head of Household (“SE”).