Nursing facilities must display written information and provide both oral and written information to residents and applicants about how to apply for and use Medicare and Medicaid benefits, and how to receive refunds for retroactive eligibility payments. Staff may use materials from the State Medicaid agency or federal government to satisfy the written requirement, but must actively assist residents in connecting with the Social Security Office or State Medicaid agency—not merely provide a phone number—to satisfy the oral requirement.
View official sourceF579 (Rev. 173, Issued: 11-22-17, Effective: 11-28-17, Implementation: 11-28-17) §483.10(g)(13) The facility must display in the facility written information, and provide to residents and applicants for admission, oral and written information about how to apply for and use Medicare and Medicaid benefits, and how to receive refunds for previous payments covered by such benefits. DEFINITIONS §483.10(g)(13) “Refunds for previous payments” refers to refunds due as a result of Medicaid and Medicare payments when eligibility has been determined retroactively. GUIDANCE §483.10(g)(13) To fulfill this requirement, facility staff may use written materials issued by the State Medicaid agency and the Federal government relating to these benefits. Facilities may fulfill their obligation to orally inform residents or prospective residents about how to apply for Medicaid or Medicare by assisting them in working with the local Social Security Office or the local unit of the State Medicaid agency. Simply providing a phone number is not sufficient in assisting resident or the resident representative. Facilities are not responsible for orally providing detailed information about Medicare and Medicaid eligibility rules.