AGED Discounted Nursing Home and Assisted Living Facility
Important Note: AGED’s Discounted Fee Agreement is for individuals applying for/ on ICP or HCBS Medicaid and residing in a Nursing Home or Assisted Living Facility. Assets must be less than $5,000. If assets are above $5,000 please use AGED’s d(4)(C) Pooled Trust Documents.
- Documentation Needed for Establishing a Pooled Trust
- Discounted Fee Agreement for Nursing Home Medicaid_Fillable
- AGED Discounted ALF and Nursing Home Joinder Agreement_Fillable 09-17-2024
- DCF Community Partner Release
- Online Access Form_Fillable
- Sample Petition and Order Authorizing Guardians to Establish a Pooled Trust
- Authorization to Disclose Trust Info_Fillable
- AGED Master Trust
- Note: Does not need to be returned to AGED
- AGED Welcome Letter
- Note: Does not need to be returned to AGED
- Funding Instructions
- Disbursement Request Form_Fillable