PM 20-08-14.

  1. (Facility) Completes Report on Resident of Private Long Term Care Facility (Form 26), for an individual:
    • who enters facility, or
    • who applies for aid while living in facility, or
    • who transfers between facilities.
  2. (FCRC) Return form to facility if it is incomplete.
  3. (FCRC) Approve application, after returning Form 26, if client is eligible, but do not approve payment until it is completed and returned to the FCRC.
  4. (FCRC) Do not approve payment until a completed Form 26 is received.

The date the facility completes Form 26 does not affect the effective date for payment.

Example: A client enters a facility 04/16/05. The screening requirement is met 04/16/05. The Family Community Resource Center receives a completed Form 26 on 04/25/05. Approve payment effective 04/16/05.

Information on Form 26 may affect the effective date for payment.

Example: The person enters a facility 04/16/05 and applies for aid on 04/18/05. The person is eligible effective 04/05. The screening requirement is met 04/16/05. The Form 26 shows that payment has already been made for 04/05 and 05/05. Approve payment starting 06/01/05.

Out-of-State Placement (Long Term Care)

Payment is not to be approved unless prior approval is obtained from BLTC and an appropriate bed cannot be found in Illinois.

  1. Do not approve payment for out-of-state placement when the client wants the placement for personal reasons.
  2. Advise the client or family to apply for aid in the state where the facility is located if they want the client placed out-of-state for personal reasons.

If the client becomes ill while temporarily out-of-state:

The FCRC may approve payment to out-of-state facility.