The purpose of this State Plan Amendment (SPA) is to enhance the Nursing Facility Services sections for both the Nursing Facility and IMD over 65 benefits by adding clarifying language to the authorization process. The SPA also removes obsolete language and adds language for both the Nursing Facility and IMD over 65 benefits (including IMD over 65 inpatient hospital services) to update terminology and demonstrate adherence to federal and state requirements.