and instructions for completion shall be provided to the nursing home by the
(2) The nursing home
must provide applications for grant assistance, as prescribed by the
department, to all interested residents upon request.
(3) The nursing home must provide the
necessary information to interested applicants in order to apply for grant
assistance. Such information shall include certification of the number of days
the individual has resided in the nursing home during the grant period for
which no reimbursement was received from any state and/or federal medical care
program and the per day expense for care at the nursing home. The nursing home
is not required to compute the applicant's income nor ensure that the applicant
actually files the application.
The nursing home shall complete its certification and information required on
the application form for each resident who desires to apply for grant
assistance (including any person who previously resided in the facility but is
no longer a resident at the time of application for grant assistance). The
completed nursing home certification and information portion of the application
shall be provided to each interested applicant no later than 15 days after the
end of the period reflected on the application.
(5) It is the applicant's responsibility to
complete his portion of the application and submit the completed application to
(6) The applicant
shall immediately notify the department of any changes that need to be made to
the applicant's portion of previously filed application.
(7) A separate application must be filed for
each nursing home in which the applicant resided for which grant assistance is
for grant assistance must be postmarked no later than July 31 following the
State's Fiscal Year in which the requested grant period occurred except for
residents who have previously been ineligible to apply for grant assistance due
to having filed an application for state and/or federal medical care program
for which a final determination has not been made. In those cases, the
applicant has thirty (30) days to file for grant assistance after being
informed of the final determination on his application for the state and/or
federal medical care program. At that time, even if approved for the state
and/or federal medical care program, the applicant can request grant assistance
for any days for which the state and/or federal medical care program did not
provide financial per them reimbursement for his nursing home care and for
which grant assistance has not been previously provided.
(9) A new application must be filed for each
state fiscal year in which grant assistance is requested after at least one
month of nursing home care is received.
(10) Only one (1) application per state
fiscal year must be filed for each nursing home in which the applicant