Common use of Medicaid Clause in Contracts

Medicaid. If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements, and the Resident is not entitled to any other third-party coverage, the Resident should be eligible for Medicaid (see Attachment “B”), often referred to as the “payor of last resort.” THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS AND/OR INSURANCE COVERAGE TO CONFIRM THAT THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR HAS OR WILL SUBMIT A TIMELY MEDICAID APPLICATION AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO APPLY FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. If the Resident’s care is covered by Medicaid, the Resident, Designated Representative and/or Sponsor agree to remit to the Facility the Resident’s Net Available Monthly Income or “NAMI” on a timely basis, pursuant to the Resident’s Medicaid budget (see Attachment “B”). The Resident’s NAMI, as determined by Medicaid, generally equals his or her income (for example Social Security income, pension income, etc.) which is available to offset the cost of care after all allowable deductions have been made. The Facility has no control over the determination of NAMI amounts. When the Resident is awaiting the issuance of a Medicaid budget, the Resident, Designated Representative and/or Sponsor shall remit the anticipated NAMI to the Facility in a timely manner as discussed more fully below.

Medicaid. If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements, and the Resident is not entitled to any other third-party coverage, the Resident should be eligible for Medicaid (see Attachment “B”), often referred to as the “payor of last resort.” THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS AND/OR INSURANCE COVERAGE TO CONFIRM THAT THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR HAS OR WILL SUBMIT A TIMELY MEDICAID APPLICATION AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO APPLY FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. If the Resident’s care is covered by Medicaid, the Resident, Designated Representative and/or Sponsor agree to remit to the Facility the Resident’s Net Available Monthly Income or “NAMI” on a timely basis, pursuant to the Resident’s Medicaid budget (see Attachment “B”). The Resident’s NAMI, as determined by Medicaid, generally equals his or her income (for example Social Security income, pension income, etc.) which is available to offset the cost of care after all allowable deductions have been made. The Facility has no control over the determination of NAMI amounts. When the Resident is awaiting the issuance of a Medicaid budget, the Resident, Designated Representative and/or Sponsor shall remit the anticipated NAMI to the Facility in a timely manner as discussed more fully belowmanner.

Medicaid. If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements, and the Resident is not entitled to any other third-party coverage, the Resident should be eligible for Medicaid (see Attachment “B”), often referred to as the “payor of last resort.” THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS AND/OR INSURANCE COVERAGE TO CONFIRM THAT THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR HAS OR WILL SUBMIT A TIMELY MEDICAID APPLICATION AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO APPLY FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. If the Resident’s care is covered by Medicaid, the Resident, Designated Representative and/or Sponsor agree to remit to the Facility the Resident’s Net Available Monthly Income or “NAMI” on a timely basis, pursuant to the Resident’s Medicaid budget (see Attachment “B”). The Resident’s NAMI, as determined by Medicaid, generally equals his or her income (for example Social Security income, pension income, etc.) which is available to offset the cost of care after all allowable deductions have been made. The Facility has no control over the determination of NAMI amounts. When the Resident is awaiting the issuance of a Medicaid budget, the Resident, Designated Representative and/or Sponsor shall remit the anticipated NAMI to the Facility in a timely manner as discussed more fully below.

Medicaid. If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements, and the Resident is not entitled to any other third-party coverage, the Resident should be eligible for Medicaid (see Attachment “B”), often referred to as the “payor of last resort.” THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS AND/OR INSURANCE COVERAGE TO CONFIRM THAT THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR HAS OR WILL SUBMIT A TIMELY MEDICAID APPLICATION AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO APPLY FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. If the Resident’s care is covered by Medicaid, the Resident, Designated Representative and/or Sponsor agree to remit to the Facility the Resident’s Net Available Monthly Income or “NAMI” on a timely basis, pursuant to the Resident’s Medicaid budget (see Attachment “B”). The Resident’s NAMI, as determined by Medicaid, generally equals his or her income (for example Social Security income, pension income, etc.) which is available to offset the cost of care after all allowable deductions have been made. The Facility has no control over the determination of NAMI amounts. When the Resident is awaiting the issuance of a Medicaid budget, the Resident, Designated Representative and/or Sponsor shall remit the anticipated NAMI to the Facility in a timely manner as discussed more fully belowmanner.

Medicaid. If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements, and the Resident is not entitled to any other third-party coverage, the Resident should be eligible for Medicaid (see Attachment “B”), often referred to as the “payor of last resort.” THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS AND/OR INSURANCE COVERAGE TO CONFIRM THAT THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR HAS OR WILL SUBMIT A TIMELY MEDICAID APPLICATION AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO APPLY FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. If the Resident’s care is covered by Medicaid, the Resident, Designated Representative and/or Sponsor agree to remit to the Facility the Resident’s Net Available Monthly Income or “NAMI” on a timely basis, pursuant to the Resident’s Medicaid budget (see Attachment “B”). The Resident’s NAMI, as determined by Medicaid, generally equals his or her income (for example Social Security income, pension income, etc.) which is available to offset the cost of care after all allowable deductions have been made. The Facility has no control over the determination of NAMI amounts. When the Resident is awaiting the issuance of a Medicaid budget, the Resident, Designated Representative and/or Sponsor shall remit the anticipated NAMI to the Facility in a timely manner as discussed more fully belowmanner.

Medicaid. If and when the Resident’s assetsfunds/funds assets have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements, and the Resident is not entitled to any other third-third party coverage, the Resident should be eligible for Medicaid (see Attachment “B”), often referred to as the “payor of last resort.” THE RESIDENT. The Resident, DESIGNATED REPRESENTATIVE AND/OR SPONSOR Resident’s Spouse, Financial Sponsor and Designated Representative JOINTLY AND SEVERALLY AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS AND/OR INSURANCE COVERAGE TO CONFIRM THAT THE RESIDENT, DESIGNATED REPRESENTATIVE RESIDENT AND/OR SPONSOR DESIGNATED REPRESENTATIVE HAS OR WILL SUBMIT A TIMELY MEDICAID APPLICATION AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO APPLY FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. If the Resident’s care is covered by Medicaid, the Resident, Resident’s Spouse, Financial Sponsor and Designated Representative and/or Sponsor jointly and severally agree to remit to the Facility the Resident’s Net Available Monthly Income or (“NAMI” ”) on a timely basis, pursuant to the Resident’s Medicaid budget (see Attachment “B”). The Resident’s NAMI, as Medicaid budget and the NAMI amount will be determined by Medicaid, generally equals his or her income (for example Social Security income, pension income, etc.) which is available to offset the cost of care after all allowable deductions have been made. The Facility has no control over the determination of NAMI amounts. When The Resident, Resident’s Spouse, Financial Sponsor and Designated Representative is obligated to pay the private pay or daily basic rate up to the time the Resident is determined eligible for and receives coverage for Medicaid for nursing home services by a local, state or federal agency. In the event of retroactive payment by Medicaid, the Facility agrees to reimburse the Resident the private pay or daily basic rate paid to the Facility from the date established for commencement of Medicaid eligibility and receipt of coverage to the date of the Medicaid determination, less NAMI monies required to be paid to the Facility. To the extent the Resident’s assets are exhausted or unavailable to pay the full daily basic rate pending the processing of the Medicaid application, the Resident, Resident’s Spouse, Financial Sponsor and Designated Representative jointly and severally agree to pay the Resident’s monthly income as partial payment of the daily basic rate until Medicaid eligibility is established, subject to the Facility’s obligation to refund any excess amounts received based on the Medicaid determination and the establishment of the Resident’s NAMI contribution. Where the Resident is awaiting the issuance of a Medicaid budget, the Resident, Resident’s Spouse, Financial Sponsor and Designated Representative and/or Sponsor shall remit to the Facility the anticipated NAMI to the Facility in a timely manner manner. In the event the Medicaid application or Medicaid recertification is denied due to a transfer of assets within the applicable Medicaid “look-back” period or due to an equity interest in the Resident’s home that exceeds the current equity interest limitation, the Resident and the Resident’s Spouse, Financial Sponsor and Designated Representative jointly and severally agree to take one or more of the following actions, as discussed more fully below.appropriate, to qualify for or to continue eligibility for Medicaid:

Medicaid. If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements, and the Resident is not entitled to any other third-party coverage, the Resident should be eligible for Medicaid (see Attachment “B”), often referred to as the “payor of last resort.” THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS AND/AND/ OR INSURANCE COVERAGE TO CONFIRM THAT THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR HAS OR WILL SUBMIT A TIMELY MEDICAID APPLICATION AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO APPLY FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. If the Resident’s care is covered by Medicaid, the Resident, Designated Representative and/or Sponsor agree to remit to the Facility the Resident’s Net Available Monthly Income or “NAMI” on a timely basis, pursuant to the Resident’s Medicaid budget (see Attachment “B”). The Resident’s NAMI, as determined by Medicaid, generally equals his or her income (for example Social Security income, pension income, etc.) which is available to offset the cost of care after all allowable deductions have been made. The Facility has no control over the determination of NAMI amounts. When the Resident is awaiting the issuance of a Medicaid budget, the Resident, Designated Representative and/or Sponsor shall remit the anticipated NAMI to the Facility in a timely manner as discussed more fully belowmanner.

Medicaid. If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements, and the Resident is not entitled to any other third-party coverage, the Resident should be eligible for Medicaid (see Attachment “B”), often referred to as the “payor of last resort.” THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS AND/OR INSURANCE COVERAGE TO CONFIRM THAT THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR HAS OR WILL SUBMIT A TIMELY MEDICAID APPLICATION AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO APPLY FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. If the Resident’s care is covered by Medicaid, the Resident, Designated Representative and/or Sponsor agree to remit to the Facility the Resident’s Net Available Monthly Income or “NAMI” on a timely basis, pursuant to the Resident’s Medicaid budget (see Attachment “B”). The Resident’s NAMI, as determined by Medicaid, generally equals his or her income (for example Social Security income, pension income, etc.) which is available to offset the cost of care after all allowable deductions have been made. The Facility has no control over the determination of NAMI amounts. When the Resident is awaiting the issuance of a Medicaid budget, the Resident, Designated Representative and/or Sponsor shall remit the anticipated NAMI to the Facility in a timely manner as discussed more fully belowmanner.

Medicaid. If and when the Resident’s assets/funds have fallen below the Medicaid eligibility levels, and the Resident otherwise satisfies the Medicaid eligibility requirements, and the Resident is not entitled to any other third-party coverage, the Resident should be eligible for Medicaid (see Attachment “B”), often referred to as the “payor of last resort.” THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO NOTIFY THE FACILITY AT LEAST THREE (3) MONTHS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S FUNDS AND/OR INSURANCE COVERAGE TO CONFIRM THAT THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR HAS OR WILL SUBMIT A TIMELY MEDICAID APPLICATION AND ENSURE THAT ALL ELIGIBILITY REQUIREMENTS HAVE BEEN MET. THE RESIDENT, DESIGNATED REPRESENTATIVE AND/OR SPONSOR AGREE TO APPLY FOR MEDICAID BENEFITS PRIOR TO THE EXHAUSTION OF THE RESIDENT’S RESOURCES. Services reimbursed under Medicaid are outlined in Attachment “A” to this Agreement. If the Resident’s care is covered by Medicaid, the Resident, Designated Representative and/or Sponsor agree to remit to the Facility the Resident’s Net Available Monthly Income or “NAMI” on a timely basis, pursuant to the Resident’s Medicaid budget (see Attachment “B”). The Resident’s NAMI, as determined by Medicaid, generally equals his or her income (for example Social Security income, pension income, etc.) which is available to offset the cost of care after all allowable deductions have been made. The Facility has no control over the determination of NAMI amounts. When the Resident is awaiting the issuance of a Medicaid budget, the Resident, Designated Representative and/or Sponsor shall remit the anticipated NAMI to the Facility in a timely manner as discussed more fully below.