Family Care Member Income Calculation for Payment of Room and Board in Substitute Care
Webcast (help) - Instructions for Standardizing Member Income Considered Available for Room and Board March 10, 2010; Presenters: Charles Jones and Deb Rathermel, Division of Long Term Care; 52 minutes (PowerPoint Handouts, PDF, 109 KB)
For purposes of considering funds available to pay for room and board, all VA allowances should be considered unearned income on line 11 of the automated PPS version or on line 4 of the Excel version of the tool for determining a member's income available to pay for room and board in substitute care.
Specialized medical equipment and supplies is a benefit that is not available at the non-Nursing Home Level of Care and therefore costs of OTC (over the counter) paid out-of-pocket by the member are considered deductions for purposes of determining both cost share and room and board.
The MCO should examine available information about the member's earned and unearned income for the past 12 months and use it to calculate prospective average monthly earned and unearned income for the member. The MCO should enter that average monthly earned and unearned income information it has calculated into the appropriate fields in lines 10 and 11 of the automated room and board liability tool.
The examination of available information about the member's earned and unearned income for the past 12 months should be reviewed at least every six months and the prospective averages recalculated.