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5007/5008 and document any changes. Review the record for any transfer of assets. (Refer to MA- 2240, Transfer of Assets.) Complete the community spouse resource protection assessment if the a/b has a community spouse. (Refer to MA-2231, Community Spouse Resource Protection.) 2. Use PLA budgeting for the month the CPI begins for both a single or married a/b. However, if the a/b enters a nursing facility, ICF-MR, swing bed/inappropriate level of care bed, or psychiatric hospital during this first month, a pml is assigned to the medical facility for claims purposes as follows: a. A/B is authorized the entire month for Medicaid prior to entering the hospital or medical facility. Assign a $0 pml. NC FAST generates the DHB-5016 for this month only. b. A/B meets Medicaid deductible before entering a nursing facility in the same month. Assign a $0 pml to the facility and send a manual DHB- 5016, Notification of Eligibility for Medicaid/Amount and Effective Date of Patient's Liability. c. A/B is not authorized (has to meet a deductible) for Medicaid prior to entering the medical facility. The medical facility charges help to meet the deductible. (1) When the individual enters a hospital and has no Medicare coverage that meets their deductible. Refer to MA-2360, Medicaid Deductible. (a) Report their deductible balance to the hospital as instructed in MA-2360, Medicaid Deductible.

(b) If they go into long-term care in that month report a $0 PML as instructed in XI.A.2.b. (2) When the individual enters a nursing facility or psychiatric residential facility, the facility’s daily private rate is applied to the deductible. When the deductible is met, assign the amount of facility charges incurred on the date the deductible is met to the facility. A DHB-5016 will be automatically generated and the county does not have to send a manual DHB-5016, Notification of Eligibility for Medicaid/Amount and Effective Date of Patient's Liability.

3. Begin LTC budgeting the month after the month the CPI begins following instructions in V., above.

4. Notify the beneficiary of the patient monthly liability (PML) amount.

a. Timely notice is required to budget LTC and assign PML to an authorized PLA beneficiary who remains in a general hospital and continues to receive acute care for more than thirty continuous days Docusign Envelope ID: 950E9248-29CC-8930-81BC-BCEC667EB493