All Medicaid Programs

Obsolete Policy

 

Obsolete 0620 - 414-1 Determining Total Income

Effective Date: November 1, 2017 - May 31, 2020 (414-1 incorporated into 463 sections as of June 1, 2020)

Previous Policy for Short-Term Stay for Unmarried Clients (Renamed as of November 1, 2017)

Previous Policy Determining Total Income

 

Total Income

 

For the process of determining the client’s contribution to the cost of care consider only the client’s income 401-3. Use total income excluding only the following types of income:

SSI and SSP benefits paid under 1611(e)(1)(E) and (G) of the Act to individuals who receive care in a hospital, nursing home, SNF, or ICF.

Austrian Reparation Payments

German Reparations Payments made by the Federal Republic of Germany.

Japanese and Aleutian Restitution Payments.

Netherlands Reparation Payments based on Nazi, but not Japanese, persecution during World War II.

Payments from the Agent Orange Settlement Fund or any other fund established pursuant to the settlement in regard to Agent Orange product liability litigation.

Radiation Exposure Compensation.

VA pensions limited to $90 per month under 38 U.S.C. 5503.

Federal tax refunds, including tax credits included in the refund amount are not counted as part of total income to determine the client's cost of care contribution.

Payments received by an American Indian/Alaska Native under the Individual Indian Money Account Litigation Settlement as required by Pub. L. 111-291 (403-16and 403-4.12).

The client’s total income includes all other income, even income that is not counted for other programs.

 

How to Count SSI and SSP

 

Do not count SSI payments for the first three calendar months after the client enters the nursing home. After 3 months, count any SSI and SSP (661) received by the client to determine the client's contribution to the cost of care.  

If the payment is not reduced to $30 after the first three months do not count the money if you verify the client has returned the money to SSI.  If necessary, help the client return the money to SSI.  If the client refuses to return the money to SSI count it as income.  If, after counting the payment, SSI contacts the client or nursing home and requests a refund adjust the payment system to reimburse the nursing home after you have received verification the check has been returned.