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CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

235 v) The resident is discharged to his/her home, and the Eligibility Site determines that the income is necessary for living expenses; or vi) The resident is admitted from another Long Term Care institution or from private pay within the facility and has committed the entire patient payment for the month for payment of care already provided in the month of admission. vii) Medicare assesses a co-insurance payment for a QMB recipient; the recipient’s patient payment cannot be used for payment of Medicare co-insurance. b. Patient payment may not be waived in the following instances: i) Transfers between nursing facilities, except that the patient payment for the receiving facility may be waived if the patient payment has already been committed to the former nursing facility; or ii) Discharges from nursing facility to a hospital or other medical institution when Medicaid is paying for services in the medical institution; or iii) Changes from private pay within the facility and the patient payment is not already committed for care provided under private pay status; or iv) The death of the resident. c. The Eligibility Site shall verify and approve partial month patient payments due to transfers, discharges or death when calculated by the nursing facility based upon the nursing facility’s per diem rate. d. The amount of SSI benefits received by a person who is institutionalized is not considered when calculating patient payment. 5. Responsibilities of the Eligibility Site Regarding the Personal Needs Fund