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MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID LONG TERM CARE SERVICES F-300 PERSONS INSTITUTIONALIZED LESS THAN 30 CONSECUTIVE DAYS A client in this group must have countable income below SSI payment levels and must be an inpatient in a skilled nursing facility (SNF), intermediate care facility (ICF or ICF/MR), or hospital and meet all eligibility requirements. In determining the number of days in a medical institution for eligibility purposes, include the day of admission, but not the day of discharge/death. An "outpatient" stay is less than a 24–hour period regardless of the hour of admission, whether or not a bed is used or whether or not the patient remains in the facility past midnight. F-305 ELIGIBILITY EXCEPTIONS a. All individuals under age 65 who are inpatients in an institution for mental disease (IMD), i.e., freestanding psychiatric hospital, are not eligible for Medicaid in this category. An IMD is defined as a hospital, nursing facility or other institution of more than 16 beds which is primarily engaged in providing diagnosis, treatment or care of persons with mental diseases, including medical attention, nursing care and related services. Individuals are severely psychotic, emotionally ill, suicidal and a danger to themselves, others or property. In Nevada IMDs are commonly referred to as "psychiatric hospitals." An institution for the mentally retarded IS NOT an institution for mental disease. b. An inmate of a public institution is ineligible for Medicaid UNLESS the institution is a medical institution. An inmate of a penal institution is NEVER eligible for Medicaid while in the custody of law enforcement officials, UNLESS admitted as an inpatient to a hospital, nursing facility, juvenile psychiatric facility, or intermediate care facility. This individual is eligible for any Medicaid covered services provided to them while an inpatient in these facilities and they are Medicaid- eligible. If this individual becomes an inpatient of a long-term care facility, they must meet level of care and plan of care assessments to become eligible. c. Individuals under 22 receiving inpatient psychiatric services in a residential treatment center (RTC) are eligible for Medicaid in this category. RTCs specialize in treating children with conduct, personality and emotional disorders, depression, hyperactivity, academic failure, and/or mild learning disabilities. Medicaid will pay for services provided in a RTC if the referral resulted from a "Healthy Kids" screening and the admission was prior authorized/certified by Medicaid's Peer Review Organization (PRO). These cases must also be evaluated for QMB eligibility.

Division of Welfare and Supportive Services LONG TERM CARE SERVICES Medical Assistance Manual PERSONS INSTITUTIONALIZED LESS THAN 30 CONSECUTIVE DAYS – 24 Sept MTL 05/24 ELIGIBILITY EXCEPTIONS F-300