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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 5

b. LTCF

Evidence of an individual’s institutional status includes:

i. An approved PAE in the appropriate TennCare Pre-Admission Evaluation System (TPAES) queue; or ii. A completed Form 2350, a form submitted by entities such as hospitals and nursing homes to notify TennCare of the applicant’s admission to the facility. The form includes the admission date and other pertinent information regarding the individual’s confinement, states where the individual is located and/or how long the individual was confined.

c. Confinement to an IMD

Form 2350 from a Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) facility is sufficient evidence that the unit to which the individual was admitted is one qualified for TennCare Medicaid reimbursement. The voluntary admission form the individual signed prior to admission to substantiate that the individual is not an inmate.

d. Enrollment in HCBS

The individual must have an approved PAE to be eligible to receive HCBS. An approved PAE is verification of institutionalized status.

7. Patient in an IMD

Patient includes an individual receiving professional services in an IMD, but does not include an individual on conditional release or convalescent leave from such an institution.

8. Coverage for Former Patients and Inmates of IMDs

a. Overview

A qualifying individual who is no longer a patient in an IMD or has had his inmate status interrupted may be eligible for TennCare Medicaid benefits upon his admission to a medical institution that is a Title XIX facility. Interruption of IMD patient status occurs when the individual is released, transferred from or receives convalescent leave from an IMD. Inmate status is interrupted when an individual is admitted to a medical institution unless he was admitted under the penal system, which requires release from the institution, i.e., parole, pardon, bail or dismissal of charges.