WAC 388-513-1396 Clients living in a fraternal, religious, or benevolent nursing facility

This section describes how the department determines eligibility for long-term care (LTC) services for a client living in a fraternal, religious, or benevolent nursing facility.  

1. For a client living in a licensed nursing facility operated by a fraternal, religious, or benevolent organization, who meets all other eligibility requirements, the department approves institutional  services and noninstitutional medical assistance, if:

   1. Any contract between the client and the facility excludes such benefits on a free or prepaid basis for life; or

   2. The facility is unable to fulfill the terms of the contract and has:

      1. Voided the contract; and

      2. Refunded any of the client's existing assets to the client.

2. For a client described in subsection (1), the department denies institutional services and noninstitutional medical assistance, if the client:

   1. Signs a contract with the organization that includes such benefits on a free or prepaid basis for life; and

   2. Surrenders income and/or resources to the organization in exchange for such benefits.