Medicaid Nursing Facility Provider Information
The Department of Children and Families (DCF) district offices staff determines
eligibility for Institutional Care Program (ICP) services.
- To begin the ICP application process, a nursing facility refers the resident
to the DCF by completing a
Client Referral Notice [PDF 21K], CF-ES Form 2506A.
- Providers must use the
Client Discharge and Change Notice [PDF 25K], CF-ES Form 2506, to advise public assistance
specialists of the placement status of institutional Medicaid
applicants and recipients.
Copies of these forms are also available from the
Department of Children and Families,
Office of Economic Self Sufficiency.
