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EAZ
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Revised December 31, 2007 |
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Purpose: |
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WAC 388-515-1540 Effective June 15, 2008
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Calculating Cost of Care DSHS uses the daily rate for the community residential facility. In order to project what the cost would be monthly, multiply the specific facility’s daily rate X 30.42. The result is the projected monthly cost of care. | ||||||||||||||||||||||||||||
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MNRW and Spenddown
Client Responsibility Toward Cost of Care Active MNRW clients must contribute towards their cost of care. The client’s responsibility is calculated using their gross non-excluded income (not-countable income) and reducing it by allowed deductions. The amount of non-excluded income remaining after the deductions is called available income. This available income is the amount of the client’s contribution. (See Scenarios 1-3.) Do not allow the private charges for a residential facility as a medical expense. These charges are not considered a medical expense. Exception To Rule (ETR)
Using the Correct PNA Determining the correct Personal Needs Allowance (PNA) that should be used in the client responsibility calculation depends on the living arrangment from the first to the end of the month. The highest PNA based on living arrangement and service is allowed. Unlike the COPES or nursing facility program, marital status does not have an affect on the client’s PNA. See LTC standards and PNA chart for current PNA amount
Splitting Client Responsibility Between Facilities When an active Medicaid client transitions to the MNRW program, the client’s contribution towards the cost of care may need to be split between the facilities for the month the client made the move. To determine how much the client’s contribution is towards the new facility:
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