Nursing facilities are licensed long term care facilities which provide round the clock medical, nursing and attendant care.  People entering a nursing facility must be prior approved by Medicaid’s fiscal agent.  Prior approval is granted only if recipients meet the state’s medical criteria for admission. 

The federal Pre-admission Screening and Annual Resident Review (PASARR), which also must be met, screens and evaluates applicants and residents of Medicaid-certified nursing facilities for mental illness, mental retardation, developmental disabilities and related conditions.

Physicians are required to complete a form which establishes medical necessity for the person entering a long term care facility.

Nursing facility services are mandatory for individuals over age 21.  Medicaid's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program requires that states offer these services, if medically necessary, to children up to age 21.