Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth

	Eligibility Operations Memo 07-10
	July 1, 2007

TO:	MassHealth Eligibility Operations Staff

FROM:	Russ Kulp, Director, MassHealth Operations

RE:	Residency Requirement Change to the Senior Medical Benefit Request (SMBR)
		

Introduction
Effective January 2007, a question has been added to the Head of 
Household/Applicant section of the Senior Medical Benefit Request (SMBR) that 
asks if an individual was placed in a nursing facility by another state.

Nursing Home Placements
During the past year, in several instances, individuals from other states 
have been placed in nursing homes by the other state’s Medicaid agency.

Changes to the SMBR were made because the transferring state is responsible for 
the individual’s care and maintenance. The nursing facility should bill the 
other state for the duration of the individual’s nursing facility stay.

If the intake worker sees the new question on the SMBR (“Were you placed here 
by another state?”) answered yes, the worker should contact the nursing facility 
to verify that this individual was placed there by another state. If that is 
correct, the application should be denied for residency, since the applicant is 
not a resident of Massachusetts.

Nursing facilities must not file applications or send SC-1 forms for individuals 
placed in their facilities by other states. The MassHealth Office of Long Term 
Care (OLTC) is working with MassHealth Operations to ensure that the nursing 
facilities are reminded of this procedure.

The Aging Services Access Point (ASAP) should not process a pre-admission 
referral if the individual’s stay is being paid for by another state’s Medicaid 
agency.

When an individual is placed by another state, it is that state’s 
responsibility to pay the nursing facility (see 130 CMR 517.003(A)).

Individuals who Move to Massachusetts
If an individual from another state moves into a long-term-care facility with 
the intention of remaining in Massachusetts permanently, he or she may apply for 
MassHealth.

If an individual is seeking MassHealth payment from the first day in a nursing 
facility, the individual must contact an ASAP before admission. The ASAP must 
determine that the individual meets MassHealth 
requirements and that he or she is clinically eligible for nursing facility 
services.

Questions
If you have any questions about this memo, please have your MEC designee contact 
the Policy Hotline.