An annual review, redetermination of financial eligibility, is required for the continuation of benefits. The current income and resources of the individual receiving Nursing Facility benefits must be verified. The income of the spouse, if any, must be verified for the purpose of deeming. The resources of the spouse must be reviewed to verify whether or not a transfer of assets has occurred. See article entitled “Transfer of Assets-After Certification”.

All current income, medical expense, and resource information of client should be entered in the appropriate FACS blocks and FACS case notes must be entered.

If client continues to be financially eligible the Social Services Specialist must update the “Type Action Taken” block in the Medical General Tab with CHANGE OF INFORMATION WHICH DOES NOT AFFECT SECTION STATUS and the “Date of Last Redetermination” block with the next effective date. No change is made to the authorization.

If it is determined that client is no longer financially eligible the Social Services Specialist has the responsibility to close the Nursing Facility authorization and update the “Type Action Taken” block in the Medical General Tab with CLOSED and enter the appropriate reason for closure, if client is not eligible for Medicaid coverage without the NF benefit.

If the case has a Medicaid Income Pension Trust see the Long Term Care training article entitled “Medicaid Income Pension Trust – Review”.