FMJ5 (Facility and Placement Information Details)

If a participant lives in a medical facility, details of the facility and placement are captured on this screen.

When the Eligiblity Specialist comes to this screen for the first time on an application, the dynamic screen below appears.

FAMIS uses the “Type of Facility” and “Type of Bed” fields to determine which program budget (RCF, ALF, SNF, etc.) to run. When FAMIS finds a combination of SNF and T19, vendor eligibility is determined. When FAMIS finds a combination of ALF and ALF, Supplemental Nursing Care (SNC) eligibility is determined.

More information regarding other fields shown:

• The DMH Placement field is used to determine the correct SNC personal needs allowance.
• Verification – hard copy or telephone call – of the placement is required.
• The “Expected to stay less than 30 days” field is used to determine if a person meets the definition of ‘institutionalized spouse’.

When ‘CTRL’ is pressed, FAMIS displays the program being explored, and the remainder of the screen appears, if needed, as displayed in the image below.

The bottom portion of this screen is dynamic, and captures DA-124 information. If the program being explored requires a DA-124, the information is accessible by pressing F14=I124. Print the DA-124 Inquiry Report for the case file and enter the following information in FAMIS:

• DA-124A/B Level of Care
• FSD Date
• Payment Start Date

Two additional fields display when a person is less than 22 years of age, resides in a medical facility, and is in need of psychiatric care. Complete the entries for the IM-71 Certification of Need for Psychiatric Services.