WAG 18-05-21: Change from LTC Case to Community Case

Complete Form 552:

• Item 2 -Enter the current processing month and year (MM/YY).
• Item 3 -Enter 31.
• Item 20 -Delete the long term care facility code. Enter the unit composition code.
• Item 33 -Enter 57.
• Item 44 -See WAG 27-44-00.
• Item 45 -Delete entry.
• Item 80 -Delete 391 or 395 and, as appropriate, 392 and 396. If the case status is changed to community spenddown, enter 390. Enter 158 CI.