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A. Request a partial month payment for the first month when an applicant enters an adult care home after the first day of the month, meets all elements of eligibility, and remains in the facility for the remainder of the month.
Request a partial month payment if the applicant is in an SA private pay room and is not financially eligible for SA Basic pay solely due to income, but moves to an SCU after the first of the month, and becomes eligible for SA SCU, due to the higher SCU rate and SA income limit. Also request a partial month payment if the applicant is in the facility on the first day of the month but is not eligible for payment until a later date in the month due to state residence or FL-2/MR-2 requirements.
1. The applicant's income for the month of entry is not counted if he/she enters the facility or meets all eligibility criteria after the first day of the month.
a. Determine number of days in the month of entry (28, 29, 30, and 31).
b. Determine date of entry (using day 2 through day 31.)
c. Determine number of days for which payment is needed by subtracting date of entry from number of days in the month of entry and adding 1.
d. Determine monthly SA rate.
e. Divide the monthly SA rate by the number of days in the month of entry to determine per diem rate (Round to the nearest hundredth).
f. Multiply cost of care per diem times the number of days of care in the month to compute the cost of care.
g. Add personal needs allowance ($46.00) to the adult care home rate
h. Round amount to the nearest dollar for partial month payment.
B. Partial Payment for SA/ACH Basic Rate
Example: Mr. Smith enters the SA facility on October 5. Since he entered after the first day of the month, he is entitled to a partial month payment. His October income is not counted in determining his partial payment amount. The SA facility Basic rate is $1,182 a month. The personal needs allowance is $46 a month. The example is calculated below.
ACH charges the SA facility Basic rate.
Number of days in month of entry: 28, 29, 30, 31 |
31 |
Subtract Date of entry from number of days in the month |
- 5 |
Result plus one = Number of eligible SA days |
= 26 + 1 = 27 |
SA facility Basic Rate |
$1,182.00 |
Divide by number of days in month |
÷ 31 |
Result equals the Per Diem Rate (Round to nearest hundredth) |
= 38.13 |
Multiply by number of eligible days |
x 27 |
Result is total room and board for eligible days |
=$1029.51 |
Add the Personal needs allowance |
+ 46.00 |
Total SA Partial Payment (Round to nearest dollar.) |
= 1,075.51 |
Partial SA Payment |
$ 1,076.00 |
C. Partial Payment for SA facility SCU Rate
Example: Mr. Bailey entered the SA facility on October 5. Since he entered after the first day of the month, he is entitled to a partial month payment. His October income is not counted in determining his partial payment amount. The SA facility SCU rate is $1,515 a month. The personal needs allowance is $46 a month. The example is calculated below.
Number of days in month of entry: 28, 29, 30, 31 |
31 |
Date of entry - Enter the DAY of entry (from 2 through 31) |
- 5 |
Result plus one = Number of eligible SA days |
= 26 + 1 = 27 |
SA facility SCU Rate |
$1,515.00 |
Divide by number of days in month |
÷ 31 |
Result equals Per Diem Rate (Round to nearest hundredth) |
= 48.870 = 48.87 |
Multiply by number of SA eligible days |
x 27 |
Result is total room and board for eligible days |
=$1,319.49 |
Add the Personal needs allowance |
+ 46.00 |
Total SA payment (Round to nearest dollar.) |
= 1,365.49 |
Partial Payment |
$ 1,365.00 |
D. Partial Payment When an SA facility Private Pay a/r in Basic Care Becomes Financially Eligible for SA due to Moving to a Licensed SCU After the First Day of the Month.
Example: Mr. Bailey entered the SA facility on October 1. He was placed in a section of the SA facility that was for those needing SA facility Basic care. His current FL-2 showed a diagnosis of Dementia. He applied for SA facility Basic assistance. However, due to his income he was ineligible for the SA facility Basic rate.
On October 5 he moved to the SCU of the facility. His countable income was then within the SA facility SCU limits. Since he became eligible for SA after the first day of the month, he is entitled to a partial month payment. His October income is not counted in determining his partial payment amount. The SA facility SCU rate is $1,515 a month. The personal needs allowance is $46 a month. The example is calculated below.
Number of days in month of entry: 28, 29, 30, 31 |
31 |
Date of entry - Enter the DAY of entry (from 2 through 31) |
- 5 |
Result plus one = Number of eligible SA days |
= 26 + 1 = 27 |
SA facility SCU Rate |
$1,515.00 |
Divide by number of days in month |
÷ 31 |
Result equals Per Diem Rate (Round to nearest hundredth) |
= 48.870 = 48.87 |
Multiply by number of SA eligible days |
x 27 |
Result is total room and board for eligible days |
=$1,319.49 |
Add the Personal needs allowance |
+ 46.00 |
Total SA payment (Round to nearest dollar.) |
= 1,365.49 |
Partial Payment |
$ 1,365.00 |
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office.
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