For the purposes of this article, the following definitions shall apply:
(a) “Annuity” means a contract that names an annuitant and gives a person or entity the right to receive periodic payments of a fixed or variable sum for a described period of time, which may include a lump-sum payment or periodic payments upon the death of the annuitant.
(b) “Community spouse” means the spouse of an institutionalized spouse.
(c) “Home and facility care” means the following services that are subject to Medi-Cal reimbursement:
(1) Nursing facility care services.
(2) A level of care in any institution equivalent to that of nursing facility care services.
(3) Home- or community-based care services furnished under a waiver granted pursuant to subsection (c) or (d) of Section 1396n of Title 42 of the United States Code.
(d) “Institutionalized spouse” means any individual to whom all of the following apply:
(1) The individual is in a medical institution or nursing facility or is a person who is receiving institutional or noninstitutional services from a Program of All-Inclusive Care for the Elderly organization pursuant to Chapter 8.75 (commencing with Section 14591), and is likely to meet that requirement for at least 30 consecutive days.
(2) The individual is married to a spouse who is not in a medical institution or nursing facility, or to a spouse who is not receiving services from a Program of All-Inclusive Care for the Elderly organization pursuant to Chapter 8.75 (commencing with Section 14591).
(3) Except for purposes of Sections 14005.7, 14005.12, 14005.16, and 14005.17, an individual who is admitted to a medical institution or nursing facility on or after September 30, 1989, and who applies for Medi-Cal benefits on or after January 1, 1990, or a Medi-Cal recipient who is admitted to a medical institution or nursing facility on or after January 1, 1990.
(e) “Medical institution” has the same meaning as defined in Section 435.1010 of Title 42 of the Code of Federal Regulations.
(f) “Nursing facility” has the same meaning as defined in Section 1250 of the Health and Safety Code.
(Amended by Stats. 2011, Ch. 367, Sec. 7. (AB 574) Effective January 1, 2012.)
Last modified: October 25, 2018