Resource Assessment Form Pa 1572

Resource Assessment Form Pa 1572 - Facility before joint resources are expended on care A resource assessment form PA 1572 can be obtained from the long term care facility It should be submitted to the county assistance office in the county where the long term care facility is located Persons who have given away assets income or resources

These minimum and maximum figures are revised annually You can file a Resource Assessment Form PA 1572 to determine the spousal share A couple should file this form when one of them enters an LTC facility or is assessed eligible for HCBA The community spouse is not required to pay for the institutionalized spouse s long term care

Resource Assessment Form Pa 1572

Resource Assessment Form Pa 1572

 · PA 1572 is the resource assessment form that a married Medical Assistance applicant should complete when he or she moves into a skilled nursing facility. If a skilled nursing facility resident applies for long term care Medicaid benefits in Pennsylvania, completion of PA 1572 is a requirement.

PA 1572 Resource Assessment 50 pk View PDF PA 1572 S Resource Assessment Spanish 50 pk View PDF PA 1615 Outstationing Verification Checklist See below This form is not available for ordering View PDF PA 1616 Outstationing Provider Checklist See below This form is not available for ordering View PDF PA 1663 Employability

MA And Payment Of Long Term Care Department Of Human

Instructions for Completing Resource Assessment Form PA 1572 To be used by a couple when one of them is in a nursing facility other medical institution or assessed eligible for Home and Community Based Services HCBS and the other lives in the community Important information for nursing facility residents and their spouses

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The protected spousal share is determined by the caseworker at the County Assistance Office following his or her review of the Resource Assessment Form PA 1572 This form is provided to every nursing home resident upon admission in

Protecting Your Spouse S Resources

Once you have gathered the necessary information the next step is the submission of a Resource Assessment Form PA 1572 this needs to be filed where the applicant is married

Assessment Form

This information packet contains important information about your rights as a resident of a nursing facility and information about Medical Assistance MA a program which can help pay for nursing facility care for people who cannot pay all of the costs of care by themselves

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There is a Resource Assessment Form in the packet for couples who wish to have a Resource Assessment completed The PA 1572 has instructions for completing the form and providing documents to prove the information as of the date of admission

Resource Assessment Form Pa 1572

This information packet contains important information about your rights as a resident of a nursing facility and information about Medical Assistance MA a program which can help pay for nursing facility care for people who cannot pay all of the costs of care by themselves

These minimum and maximum figures are revised annually You can file a Resource Assessment Form PA 1572 to determine the spousal share A couple should file this form when one of them enters an LTC facility or is assessed eligible for HCBA The community spouse is not required to pay for the institutionalized spouse s long term care

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