Authority: IC 10-17-9-7

Affected: IC 10-17-9; IC 16-19-3

Sec.1. (a) An applicant shall apply for admission to the home by submitting a completed application form prescribed by the home. The completed application shall be:

1. (1) signed by the applicant; and
2. (2) notarized.

(b) In addition to the application required under subsection (a), an applicant shall submit the following:

1. (1) A copy of the applicant's military discharge.

2. (2) Information concerning current income, including, but not limited to, the following:

   1. (A) Pensions.
   2. (B) Compensation or income from any source.

   3. (C) Benefits from:

      1. (i) the Social Security Administration;
      2. (ii) the railroad retirement law; or
      3. (iii) a retirement annuity or insurance annuity.
3. (3) A resident services agreement signed by the applicant.

4. (4) Either:

   1. (A) a letter by the auditor of the applicant's county of residence stating whether the applicant has owned property within the last three (3) years; or
   2. (B) the applicant's property tax statement.

5. (5) Information concerning assets including, but not limited to, the following:

   1. (A) Cash accounts, including, but not limited to, the following:

      1. (i) Cash.
      2. (ii) Checking.
      3. (iii) Savings.
      4. (iv) Security deposits.

   2. (B) Securities including, but not limited to, the following:

      1. (i) Bonds, notes, and mortgages.
      2. (ii) Stocks, options, and commodity contracts.
   3. (C) Loans to others and accounts receivable.
   4. (D) Interest in any business.
   5. (E) Real estate.
   6. (F) Vested interests in trusts.

   7. (G) Personal property, including, but not limited to, the following:

      1. (i) Jewelry.
      2. (ii) Art.
      3. (iii) Antiques.
      4. (iv) Gold and precious metals.
      5. (v) Vehicles.
6. (6) Copies of all health insurance cards and values for life insurance.
7. (7) Any other documentation that the home may require in order to determine financial assets.

(c) In addition to the application required under subsection (a) and additional items required under subsection (b), an applicant who is a spouse or surviving spouse of a veteran shall submit the following:

1. (1) A copy of the veteran's military discharge.
2. (2) A copy of a certificate of marriage to the veteran.
3. (3) If the veteran spouse is deceased, a certified copy of the death certificate.

(d) The applicant is responsible for reporting any changes that occur in the applicant's income or assets during the application and admission process.

(e) The application form required by subsection (a) and additional documentation required by subsections (b) through (d) shall be submitted to the Admissions Office, Indiana Veterans' Home, 3851 North River Road, West Lafayette, Indiana 47906.

(f) The burden is on the applicant to complete the application and submit the required documentation. An incomplete application may be returned to the applicant.

(Indiana Veterans' Affairs Commission; 915 IAC 2-2-1; filed May 11, 2007, 3:00 p.m.: 20070606-IR-410050314FRA; readopted filed Nov 26, 2014, 1:35 p.m.: 20141224-IR-915140384RFA; readopted filed Nov 19, 2020, 9:24 a.m.: 20201216-IR-915200467RFA) NOTE: Transferred from the Indiana State Department of Health (410 IAC 30-2-1) to the Veterans' Affairs Commission (915 IAC 2-2-1) by P.L.21-2008, SECTION 19, effective July 1, 2008.