Application for Medical Assistance. Responsible Person shall timely assist Resident in the preparation, completion and submission, if applicable, of Resident’s application for Medical Assistance benefits. If Facility, in its sole discretion, decides to assist in the Medical Assistance application, Resident and Responsible Person are still fully obligated to initiate, make and complete the Medical Assistance application. Facility’s assistance in the Medical Assistance application process does not waive Resident’s or Responsible Person’s duty or responsibility to timely complete and submit a Medical Assistance application if the Resident’s financial resources become insufficient to pay amounts under the Admission Agreement. The failure to initiate, make and complete the Medical Assistance application process may result in the discharge of Resident for non- payment and in personal liability to Responsible Person for losses incurred by Facility for Responsible Person’s failure to apply timely for Medical Assistance benefits. In the event Resident applies for Medical Assistance benefits, Responsible Person shall pay the Patient Pay Amount monthly to Facility. Responsible Party, at the request of Facility and to the extent permitted by law, shall immediately sign over and/or designate the Facility as the representative/designated payee for any income available to Resident in an amount not to exceed the Patient Pay Amount as determined by DHS. Responsible party should take whatever action as may be necessary to insure that such payments are made directly to Facility. Patient Pay Amount is determined by DHS and described in Subsection 5.3(b) below. If Resident is determined to be ineligible for Medical Assistance because Responsible Person fails to provide or submit necessary documents or fails to appeal timely so that Facility is unable to obtain Medical Assistance reimbursement, then Facility may terminate this Agreement for non-payment of stay and Responsible Person shall be personally liable for any losses sustained by Facility as a result of such failure. Responsible Person shall be responsible personally for compliance with all other terms of this Agreement.
Application for Medical Assistance. If an application is made for determination of an individual’s medical assistance eligibility, the hospital will contact Great Rivers BHO within the calendar day. Great Rivers BHO may not withhold an authorization number pending the outcome of medical assistance eligibility.
