Page 20

North Carolina Department of Health and Human Services AGED, BLIND, AND DISABLED MEDICAID MANUAL

MA-200

DEFINITIONS

20 REISSUED 03/01/11 – CHANGE NO. 03-11 (III.) Institutionalized – Long Term Care Budgeting/Community Spouse Resource Allowance and Continuous Period of Institutionalization. This is 30 consecutive days in a medical facility or combination of medical facilities. The facilities are nursing facility, intermediate care facility-mental retardation, (ICF-MR) swing bed, inappropriate level of care in a hospital, or hospital acute level, and psychiatric residential treatment facility (PRTF).

Institutional Services - These services include services provided in a nursing facility (NF), intermediate care facility for the mentally retarded (ICF-MR), swing bed or inappropriate level of care bed, services provided through the Community Alternatives Program (CAP), or Program of All- Inclusive Care for the Elderly (PACE). These services can be sanctioned due to a transfer of assets. These services do not include acute hospital care regardless of length of stay.

Institutionalized Spouse - An individual who is in SNF, ICF-MR, swing bed or inappropriate level of care bed, state mental hospital, or a general hospital after 30 days, or is approved for CAP/DA or CAP/MR, or PACE, and is married to a spouse who is not institutionalized.

Institutionalized for Transfer of Assets – As defined for a transfer of assets review, institutionalized is an individual receiving institutional services in a nursing facility (NF), intermediate care facility for the mentally retarded (ICF-MR), swing bed, inappropriate level of care bed in a hospital, services provided through CAP, or services provided through PACE. This is different from the definition of institutionalized for long term care budgeting or institutional living arrangement when determining state/county residency.

Intake --- An initial interview.

Intermediate Care Facility - Mental Retardation Section (ICF-MR) --- An ICF for the mentally retarded that is affiliated with the State's retardation centers or mental hospitals.

Investigation --- A thorough examination of all eligibility factors.

Irrevocable Trust --- A contract in which the terms cannot be altered.

Job Bonus --- A one time 100% exclusion of earned income for 3 consecutive months for each parent/specified relative included in the assistance unit who becomes employed. Job Bonus is applicable ONLY to MAF-C and Work First cases.

Katie Beckett --- (CAP for Children) Medicaid Community Alternatives Program to allow disabled children who are at risk for institutionalization to receive medical care at home. Term used by other states. Katie Beckett is referred to as CAP-C in North Carolina.

Lawful Permanent Resident --- An alien who is legally admitted to the U.S. by the BCIS to live and work on a permanent basis.

Legal Parent --- Natural or adoptive parent after the final order of adoption is issued.