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Elizabeth M. Whitehorn, Director

Provider Notice issued 05/21/10

 Supportive Living Facility Admission Requirements

 

To:​ Supportive Living Facilities (SLFs)​
Date:​ May 5, 2010​
Re:​ Supportive Living Facility Admission Requirements​

 

This notice informs Supportive Living Facilities (SLFs) any admission criteria requiring potential residents to pay privately for a set time period prior to applying for Medicaid is not allowed.  

 

A request to the U.S. Department of Health and Human Services’ Centers for Medicare/Medicaid Services (CMS) for clarification regarding the above issue indicates that anyone wishing to apply for Medicaid must be able to do so.

The terms of the HFS Provider Agreement states that the provider agrees to comply with all applicable federal, state and local laws and that Medicaid payment is payment in full.  The Social Security Act states that no Medicaid provider may seek to put up barriers to individuals wishing to apply for Medicaid.

Even if a person enters a SLF as a private pay resident, and are later determined to have been Medicaid-eligible at the time of admission, the SLF would have to refund any payment in excess of the amount determined by the Department of Human Services to be the patient’s responsibility.     

CMS further states that SLF providers that choose to limit services to residents who pay privately, even for a set period of time, cannot be a Medicaid provider.  Since the Supportive Living Program is a Medicaid Program, this would result in the provider’s SLF certification being withdrawn. 

Questions regarding this notice should be directed to the Healthcare and Family Services Bureau of Long Term Care at 217-524-0372.

 

Theresa A. Eagleson, Administrator

Division of Medical Programs