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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 8 Chapter 24 Long Term Care

If a Medicaid client loses eligibility and does not receive payment for nursing facility services for one month, he must reapply and is subject to the current application requirements unless the loss of eligibility or payment was due to a delay or error caused by the Department of Human Services (DOHS). If an individual transfers to a nursing facility in West Virginia, he must submit an application and his eligibility must be evaluated as any other applicant. 24.4.1.C.4 Interview Required No interview is required. 24.4.1.C.5 Who Must Sign The application must be signed by the applicant, the spouse, or the authorized representative. When the applicant is a child under age 18, the parent(s) or legal guardian must sign. ➢ Authorized Representatives The applicant may designate an authorized representative to act on his behalf. Such a designation must be in writing and include the applicant’s signature. Authority for an individual or entity to act on behalf of an applicant or beneficiary accorded under state law, including but not limited to, a court order establishing legal guardianship or a power of attorney, must be treated as a written designation by the applicant or beneficiary of authorized representation. The power to act as an authorized representative is valid until the applicant or beneficiary modifies the authorization to the DOHS. NOTE: When the applicant has completed the interactive interview, and there is a technical failure that prevents the printing of the DFA-2, Form DFA-5 must be signed by the applicant, attached and filed in the case record with the subsequently printed DFA-2. The DFA-RR-1 must also be completed when the DFA-5 has been signed.