Can a patient who qualifies for Medicaid and falls under the category of medically needy, take part in a spend down program?

Are they right now hospitalized and could there be some miscommunication with their "at-need" eligibility for Medicaid?

Medicaid has 2 different tracks for eligibility - financial (to be at whatever your state has set for impoverishment or low income) & medical (need skilled nursing care at a NH or qualify for a waiver). They have to qualify in each track to get Medicaid. If they are a patient in a hospital then the medical "at need" is probably in their medical chart so good for that. BUT they still need to qualify to be financially "at-need" for Medicaid and have to do a spend-down. Could this be the issue?

If they already qualify, there should not be any assets left to spend down.