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What It Is

​Nursing facility services included in per diem rate are room and board, dietary services, nutritional supplements, social services, activities, respiratory therapy and supplies, nursing services, the use of equipment and facilities, medical and surgical supplies, prosthetic devices, laundry services, drugs ordered by the physician and personal items routinely provided by the facility.

Other services, if medically necessary and if ordered by the physician, are X-rays, physical therapy, speech therapy, occupational therapy, laboratory services, oxygen and related oxygen supplies and may be billed separately from the per diem rate.

Eligibility

You may be eligible for nursing facility services if:

  • You reside in a facility participating in the Kentucky Medicaid Program and are placed in a Medicaid-certified bed;
  • You require and meet the nursing facility level of care criteria (as defined by Section 4 of 907 KAR 1:022) giving consideration for the medical diagnosis, age-related dependencies, care needs, services and health personnel required to meet these needs and the feasibility of meeting the needs through alternative institutional or non-institutional services; and
  • You meet the income and resource limitations required by the program.

For information on completing the Level I Screening and Level II evaluation, visit the Department for Behavioral Health, Developmental and Intellectual Disabilities PASSR website. You may access forms, manual and regulations from this site.

Apply

An application for Medicaid may be filed at your local Department for Community Based Services Office. At the time of application, an individual or family should bring proof of:

  • Social Security Number;
  • Proof of identity (drivers license);
  • Proof of citizenship (birth certificate);
  • Health insurance;
  • Medical bills
  • Income
  • Resources
  • Life insurance policies or burial reserves
  • A Medicaid application is more likely to be processed sooner if the individual or family provides the above information.

There are Medicaid Waiver programs that can provide Medicaid coverage for many different services that help you stay in your home.

Information

Nursing Home assistance: contact (502) 564-6890

Billing issues: contact (800) 807-1232

Documentation