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Aged, Blind and Disabled Manual Policy Manual Number: 125.005 Section: Institutional Medicaid Chapter: Institutional Status
November 3, 2025 Division of TennCare 3
c. Institution for Mental Disease (IMD)
An institution licensed to provide diagnosis, treatment or care for persons with mental diseases.
TennCare Medicaid reimbursement is limited to care provided for an eligible individual who is at least 65 years of age and confined to an approved ward.
Confinement in an IMD does satisfy and establish institutional status for individuals under age 65 and those confined to unapproved wards; therefore, when subsequently admitted to a medical institution these individuals may already meet confinement.
d. Public Institution
A public institution is an institution serving more than 16 residents that is the responsibility of or controlled by a governmental unit. A public institution does not include:
i. A medical institution; or ii. An intermediate care facility (ICF), including those providing services to individuals age 65 and older in institutions for tuberculosis or mental disease.
e. Institution for Tuberculosis
A facility established and maintained primarily for the care and treatment of tuberculosis. Tennessee does not have any chest disease or tuberculosis hospitals. Reimbursement is available to an out-of-state hospital for a Tennessee resident who requires such care.
4. Special Low-Income Group
The following individuals are considered to be institutionalized when confined to a medical institution (i.e. hospital) for at least 30 days and are not eligible in another TennCare Medicaid Category of Eligibility (COE):
a. Children (under 18 years of age or under 22 years of age if a student regularly attending school); b. Pregnant women; c. Aged individuals as defined in the Institutional Medicaid policy; d. Blind individuals as defined in the Institutional Medicaid policy; or e. Disabled individuals as defined in the Institutional Medicaid policy.
Note: Institutionalized individuals cannot be considered caretaker relatives as individuals confined to a medical institution for 30 days or more no longer meet the Caretaker Relative Status criteria as defined in the Caretaker Relative MAGI policy.