{"id":620,"date":"2025-02-25T17:12:42","date_gmt":"2025-02-25T17:12:42","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dmma\/ltcmedicaid\/"},"modified":"2025-10-08T11:26:34","modified_gmt":"2025-10-08T15:26:34","slug":"ltcmedicaid","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dmma\/ltcmedicaid\/","title":{"rendered":"ltcmedicaid ~  DHSS &#8211; DMMA &#8211;  Long Term Care Medicaid Programs  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\r\n\r\n\r\n\r\n\r\n\r\n  <br>\r\n\r\n\r\n  \r\n\r\n\r\n  <div class=\"container\" id=\"main_header\">\r\n\r\n\r\n    <!-- BEGIN readspeaker div -->\r\n\r\n\r\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\r\n\r\n\r\n      <a class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&amp;lang=en_us&amp;readid=main_content&amp;url=https:\/\/dhss.delaware.gov\/dmma\/ltcmedicaid.html\" title=\"Listen to this page using ReadSpeaker\">\r\n\r\n\r\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\r\n\r\n\r\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\r\n\r\n\r\n      <\/a>\r\n\r\n\r\n    <\/div>\r\n\r\n\r\n    <!-- END readspeaker div -->\r\n\r\n\r\n\r\n\r\n\r\n    <header class=\"pull-left\">\r\n\r\n\r\n      <h1><!--[type=EDIT name=\"Page Title\"]-->Long Term Care Medicaid Programs<!--[END]--><\/h1>\r\n\r\n\r\n    <\/header>\r\n\r\n\r\n  <\/div><br>\r\n\r\n\r\n \r\n\r\n\r\n  <div class=\"container\">\r\n\r\n\r\n    <div class=\"row\">\r\n\r\n\r\n      <div class=\"col-md-3\" id=\"leftCol\">\r\n\r\n\r\n        <div class=\"panel-group\" id=\"accordion\">\r\n\r\n\r\n          <div class=\"panel sectionmenu_panel\">\r\n\r\n\r\n            <div class=\"panel-heading\">\r\n\r\n\r\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Medicaid &amp; Medical Assistance Menu<\/strong><\/a><\/p>\r\n\r\n\r\n            <\/div>\r\n\r\n\r\n\r\n\r\n\r\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\r\n\r\n\r\n              <div class=\"panel-body\" id=\"clf_nav\">\r\n\r\n\r\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\r\n    <li><a href=\"\/dmma\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\r\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\r\n    <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\r\n    <li>\r\n      <a href=\"\/dmma\/about.html\">About DMMA<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/sections.html\">Sections &amp; Programs<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/faqs.html\">FAQs<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/links.html\">Related Links<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/contact.html\">Contact Information<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/locations.html\">Office Locations<\/a>\r\n    <\/li>\r\n  <\/ul><\/li>\r\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\r\n    <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">  \r\n          <li>\r\n            <a href=\"\/dmma\/services.html\">Programs and Services<\/a>\r\n    <\/li> \r\n      \r\n      \r\n    <li>\r\n      <a href=\"\/atoz\/\">A-Z of DHSS Services<\/a>\r\n    <\/li>\r\n       <li>\r\n      <a href=\"\/dmma\/adult_dental_benefits.html\">Adult Dental Benefits<\/a>\r\n    <\/li>\r\n      <li>\r\n      <a href=\"\/dmma\/homeandc.html\">Developmental Disabilities Home &amp; Community Based Waiver Program<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/medast.html\">Medical Assistance Programs<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/medicaid.html\">Medicaid<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/dhcp.html\">Healthy Children (CHIP)<\/a>\r\n    <\/li>\r\n    \r\n    <li>\r\n      <a href=\"\/dmma\/dpap.html\">Prescription Assistance (DPAP)<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/ltcmedicaid.html\">Long Term Care<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/disabledchildren.html\">Children&#8217;s Community Alternative Disability Program<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/hcbs_trans_plan.html\">Home &amp; Community Based Services Statewide Transition Plan<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/medical.html\">Transportation<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/crdprog.html\">Chronic Renal Disease<\/a>\r\n    <\/li>\r\n  <\/ul><\/li>\r\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\r\n    <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\r\n       <li>\r\n      <a href=\"\/dmma\/children_with_medical_complexity.html\">Children with Medical Complexity<\/a>\r\n    <\/li>\r\n      \r\n      \r\n    <li>\r\n      <a href=\"\/dmma\/fpl.html\">Eligibility<\/a>\r\n    <\/li>\r\n\r\n    <li>\r\n      <a href=\"https:\/\/medicaidpublications.dhss.delaware.gov\/docs\/Search?EntryId=49\">Pharmaceutical and Therapeutics (P &amp; T) Committee<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"https:\/\/medicaid.dhss.delaware.gov\/\">Provider Manuals<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/regs.html\">Regulations<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/reports.html\">Reports<\/a>\r\n    <\/li>\r\n        <li>\r\n      <a href=\"\/dmma\/info_stats.html\">Public Information and Statistics<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/pubs.html\">Publications &amp; Forms<\/a>\r\n    <\/li>\r\n    <li>\r\n      <a href=\"\/dmma\/resources.html\">Resources<\/a>\r\n    <\/li>\r\n  <\/ul><\/li>\r\n\r\n\r\n\r\n\r\n\r\n              <\/div>\r\n\r\n\r\n            <\/div>\r\n\r\n\r\n          <\/div>\r\n\r\n\r\n        <\/div><br>\r\n\r\n\r\n      <\/div>\r\n\r\n\r\n\r\n\r\n\r\n      <div class=\"col-md-9\" id=\"main_content\"> \r\n\r\n\r\n  <!--[type=HTMLEDIT name=\"Content\"]-->\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>\u00a0<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<h2>Services<\/h2>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>\u00a0<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>\u00a0<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>The <a href=\"index.html\">Division of Medicaid &amp; Medical Assistance\u2009\u2009<\/a> provides the following Long Term Care services:<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>\u00a0<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<ul>\r\n\r\n\r\n\r\n <li><a href=\"\/wp-content\/uploads\/sites\/9\/dmma\/pdf\/ltc_steps_to_ltc_202207.pdf\">Steps to Long Term Care Guide<\/a><\/li>\r\n\r\n\r\n\r\n <li>Medicaid Nursing Facility Care<\/li>\r\n\r\n\r\n\r\n <li><a href=\"homeandc.html\">Medicaid Home and Community-Based Services<\/a><\/li>\r\n\r\n\r\n\r\n <li>Medicaid 30-Day Acute Care Hospital services<\/li>\r\n\r\n\r\n\r\n <li><a href=\"disabledchildren.html\">Children&#8217;s Community Alternative Disability Program<\/a><\/li>\r\n\r\n\r\n\r\n <li>Medicaid Out-of-state Rehabilitation Hospital Services<\/li>\r\n\r\n\r\n\r\n <li><a href=\"qmb.html\">Qualified Medicare Beneficiary (QMB) programs<\/a><\/li>\r\n\r\n\r\n\r\n <li>Supplemental Security Income (SSI) related programs<\/li>\r\n\r\n\r\n\r\n<\/ul>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>\u00a0<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<h2>The Nursing Facility Program<\/h2>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>\u00a0<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>An individual applying for the Nursing Facility program must be a Delaware resident and must be willing to enter a nursing facility and accept Medicaid coverage. To apply for this program, contact the <a class=\"anchors_link\" href=\"https:\/\/dhss.delaware.gov\/dmma\/contact\/\">Medicaid Central Intake Unit.<\/a><\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>The medical criteria for this program are as follows: the applicant must be in need of a skilled or intermediate level of care as defined by Delaware Medicaid criteria. In other words, the individual must require the level of care provided by a nursing facility. If his gross monthly income exceeds the income limit for this program (set at 250% of the Supplemental Security Income &#8211; SSI &#8211; standard), he will need to establish a Miller Trust in order to qualify. His assets cannot exceed $2,000 unless he has a spouse.<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>The Nursing Facility Program pays for the cost of care provided in nursing facilities in Delaware that have contracts with Delaware Medicaid. These nursing facilities provide room, board and nursing services to persons who are elderly, infirm or disabled.<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>Official lists of all <a href=\"\/dhcq\/licfac.html\">Licensed Long Term Care Facilities in Delaware<\/a> are maintained by the <a href=\"\/dhcq\/\">Division of Health Care Quality<\/a>, which is responsible for licensing and certifying all Delaware Long Term Care facilities.<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<h2>Payment Issues:<\/h2>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<ul>\r\n\r\n\r\n\r\n <li>Medicaid may only pay for covered services after all other coverage has been exhausted. Examples of other coverage are Medicare, employment-related health insurance, Union Health &amp; Welfare Funds, workers&#8217; compensation, and no-fault automobile insurance. This is based on the <a href=\"http:\/\/www.gpoaccess.gov\/ecfr\">Code of Federal Regulations<\/a> (42 CFR 433 Subpart D) and <a class=\"anchors_link\" href=\"http:\/\/delcode.delaware.gov\/title31\/c005\/index.shtml#TopOfPage\">Delaware State Law<\/a> (Medical Care Subrogation Law &#8211; Chapter 5, Title 31, Section 522). When a recipient receives payment from an insurance carrier, court settlement, etc. for any medical services paid by Medicaid, the recipient is obligated to reimburse the program for those related services. All such cases must be referred to the Third Party Liability Unit at the Delaware <a href=\"contact.html\">Division of Medicaid &amp; Medical Assistance\u2009<\/a>.<\/li>\r\n\r\n\r\n\r\n <li>A Medicaid nursing facility resident may keep $75.00 of his monthly income for his personal needs. The rest of his income must be paid to the facility unless an amount has been protected for:\r\n\r\n\r\n\r\n <ul>\r\n\r\n\r\n\r\n  <li>The needs of a community spouse under the <strong>Spousal Impoverishment Provision<\/strong>,<\/li>\r\n\r\n\r\n\r\n  <li>Medically necessary medical equipment and medical services not covered by Medicaid (e.g. eye glasses, dentures, hearing aids&#8230;), and\/or private health insurance premiums.<\/li>\r\n\r\n\r\n\r\n <\/ul>\r\n\r\n\r\n\r\n <\/li>\r\n\r\n\r\n\r\n <li>If a patient in a Medicaid-enrolled nursing facility runs out of private funds and converts to Medicaid payment, the nursing facility <strong>cannot<\/strong> discharge the patient if there is an available Medicaid-certified bed.<\/li>\r\n\r\n\r\n\r\n <li>Federal law prohibits nursing facilities from charging Medicaid residents or their families for items and\/or services that are covered by Medicaid. Nursing facilities must provide a list of what items and services are included in the basic Medicaid rate and what items or services would require an extra charge.<\/li>\r\n\r\n\r\n\r\n <li>Nursing facilities that accept Medicaid cannot ask Medicaid residents for contributions as a condition of admission or charge fees to supplement the Medicaid rate.<\/li>\r\n\r\n\r\n\r\n<\/ul>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<p>Related Links<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n<ul>\r\n\r\n\r\n\r\n <li><a href=\"\/wp-content\/uploads\/sites\/9\/dmma\/pdf\/dshpplus_booklet.pdf\">Steps to Long Term Care Guide<\/a><\/li>\r\n\r\n\r\n\r\n<\/ul>\r\n\r\n\r\n\r\n  <!--[END]-->\r\n\r\n\r\n  \r\n\r\n\r\n      <\/div>\r\n\r\n\r\n    <\/div>\r\n\r\n\r\n  <\/div><!-- \/container -->\r\n\r\n\r\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Long Term Care Medicaid Programs Medicaid &amp; Medical Assistance Menu Home About About DMMA Sections &amp; Programs FAQs Related Links Contact Information Office Locations Services Programs and Services A-Z of DHSS Services Adult Dental Benefits Developmental Disabilities Home &amp; Community Based Waiver Program Medical Assistance Programs Medicaid Healthy Children (CHIP) Prescription Assistance (DPAP) Long [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-620","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dmma\/wp-json\/wp\/v2\/pages\/620","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dmma\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dmma\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dmma\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dmma\/wp-json\/wp\/v2\/comments?post=620"}],"version-history":[{"count":3,"href":"https:\/\/dhss.delaware.gov\/dmma\/wp-json\/wp\/v2\/pages\/620\/revisions"}],"predecessor-version":[{"id":1129,"href":"https:\/\/dhss.delaware.gov\/dmma\/wp-json\/wp\/v2\/pages\/620\/revisions\/1129"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dmma\/wp-json\/wp\/v2\/media?parent=620"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}