Page 1960

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 35 Chapter 24 Long Term Care

based on the Undue Hardship Provision. These clients may be eligible for up to 30 days of payment for bed-hold days while awaiting a decision of the Undue Hardship Committee. When a DFA-NH-3 is sent to the LTC Unit indicating availability of payment for this reason, the payment is not processed automatically. Payment for bed-hold days while awaiting a decision is not made for individuals denied due to excessive home equity. 24.7.9.B LTC Post-Eligibility Calculations (IM-NL-LTC-1) The IM-NL-LTC-1, sometimes known as the budget, is a calculation sheet used in determining eligibility for the Nursing Facility coverage group, based on 300% of the SSI payment level for an individual. It is also used to determine the client’s contribution in the post-eligibility process, regardless of the method by which he was determined eligible. It must be sent to the client or his authorized representative with forms DFA-NL-A, DFA-NL-B, DFA-NL-C, and DFA-NH-3 for notification of all case activity involving income eligibility. 24.7.9.C Determination of Community Spouse and Family Maintenance Allowance for LTC programs (IM-NL-LTC-2) The IM-NL-LTC-2 is a calculation sheet used to determine the CSMA and FMA for nursing facility cases. It must be sent to the client or his authorized representative with the appropriate notice of decision form and DFA-NH-3 for notification when there is a change in the CSMA or the FMA.

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Page 1960

Official source

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 35 Chapter 24 Long Term Care

based on the Undue Hardship Provision. These clients may be eligible for up to 30 days of payment for bed-hold days while awaiting a decision of the Undue Hardship Committee. When a DFA-NH-3 is sent to the LTC Unit indicating availability of payment for this reason, the payment is not processed automatically. Payment for bed-hold days while awaiting a decision is not made for individuals denied due to excessive home equity. 24.7.9.B LTC Post-Eligibility Calculations (IM-NL-LTC-1) The IM-NL-LTC-1, sometimes known as the budget, is a calculation sheet used in determining eligibility for the Nursing Facility coverage group, based on 300% of the SSI payment level for an individual. It is also used to determine the client’s contribution in the post-eligibility process, regardless of the method by which he was determined eligible. It must be sent to the client or his authorized representative with forms DFA-NL-A, DFA-NL-B, DFA-NL-C, and DFA-NH-3 for notification of all case activity involving income eligibility. 24.7.9.C Determination of Community Spouse and Family Maintenance Allowance for LTC programs (IM-NL-LTC-2) The IM-NL-LTC-2 is a calculation sheet used to determine the CSMA and FMA for nursing facility cases. It must be sent to the client or his authorized representative with the appropriate notice of decision form and DFA-NH-3 for notification when there is a change in the CSMA or the FMA.