Application for Payment — Nursing Home Certification to Department
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An application for grant assistance program payments must be made by the individual or such individual's legally authorized representative on forms prescribed by regulations of the department of health. Such forms shall include a certification of the individual's annual income for the calendar year immediately preceding the beginning of the state fiscal year during which grant assistance will be requested, and such certification shall be made by the individual or individual's legally authorized representative.
Following the application, the nursing home shall provide, following the provision of service, but not less than monthly, on forms prescribed by the department, a certification to the department indicating the number of days the individual resided in the nursing home during the preceding month, the per day expense for care at the facility during that period and the source or sources of payment to defray the expense. Application information and monthly certification information is subject to verification by the department.