360-6.6 Where care and services may be provided.
Medical care and services under the MA provider may be provided to a recipient residing in
his/her own home or in an approved medical institution or facility.
(a) A recipient's home may be a home where he/she receives room and
board, a family home or boarding home, an approved non-profit institution for child care,
a licensed public child care institution which accommodates no more than 25 children and
is not operated primarily for delinquent children or family-type group, or a family-type,
family care or residential care facility certified by the department or an office of the
State Department of Mental Hygiene.
(b) An approved medical institution or facility includes the following
when operated according to the Public Health Law or other applicable law:
(1) a private proprietary or non-profit nursing
home;
(2) the approved infirmary section of a home
for the aged;
(3) a public home infirmary or other similar
public facility for the chronically ill;
(4) an intermediate care facility;
(5) a facility or part of a facility for the
treatment of narcotic addiction which is operated pursuant to the provisions of Article 23
of the Mental Hygiene Law, as long as federal aid is available;
(6) an inpatient alcoholism facility;
(7) an approved hospital, nursing home, or
intermediate care facility section of a public institution operated for the care of the
mentally disabled;
(8) a State hospital for the mentally disabled
operated by the State Department of Mental Hygiene; and
(9) a hospital other than one caring primarily
for the mentally disabled.
(c) Medical care and services may be provided to a recipient in a
general or chronic disease hospital, regardless of the disease diagnosed.
(d) Medical care and services will be provided to eligible veterans and
their dependents in those parts of the New York State Home for Veterans and their
Dependents at Oxford which have been approved pursuant to law as either a nursing home or
an intermediate care facility. Such recipients will have care and services provided in a
hospital while on release from that home for the purpose of receiving care in such
hospital.
(e) Medical care and services will be provided to an eligible person
receiving inpatient psychiatric services in an institution used primarily for the care of
the mentally ill as follows:
(1) For an eligible person under 21 years of
age, such care and services must conform to federal and State standards. A team,
consisting of physicians and other qualified personnel, must determine that the care and
services are necessary on an inpatient basis and can reasonably be expected to improve the
condition being treated so that such care and services will no longer be necessary. If a
person attains the age of 21 during the course of hospitalization, such services may
continue until he/she reaches the age of 22.
(2) For an eligible person 65 years of age or
over, such care and services must conform to federal and State standards.
(3) Persons receiving inpatient psychiatric
services in an institution primarily for the care of the mentally ill who fall outside the
categories in paragraphs (1) and (2) of this subdivision are ineligible for MA.
(f) MA will be provided to an eligible person who enters or leaves a
public institution only for the part of the month in which the person is not residing in
the institution.