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B. Aged, Blind, or Disabled Adult/Child Who is an Applicant/Beneficiary 1. For all months prior to the month the CPI begins, the a/b is budgeted PLA and should be budgeted with all persons who are financially responsible for them. (Refer to MA-2260, Financial Eligibility Regulations – PLA.)

2. Effective the month the CPI begins, the budget unit is one.

a. Count only the a/b’s income and determine eligibility under private living arrangement (PLA). Do not count income of the a/b's spouse/parent.

b. Allow the reserve limit for one, plus the amount of resources protected for the spouse. Refer to MA-2231, Community Spouse Resource Protection.

c. Do not count the PLA homesite as a resource for the first month of the CPI because it was the homesite as of the "first moment." Beginning with the second month of the CPI it is no longer excluded as the a/b’s homesite. It is a countable resource unless it can be excluded on another basis (cusp's homesite, intent to return, etc.). V. LONG TERM CARE BUDGETING COMPUTATION

A. Determine Whose Income to Count

1. Count only the a/b’s income in determining financial eligibility when the a/b does not have a spouse, or the a/b is an institutionalized disabled child.

2. Count only the a/b’s income when the a/b is married but the spouse remains in a private living arrangement, or in a separate LTC facility, or they share a LTC room but only one spouse requests Medicaid to pay for cost of care.

3. Count both spouse's income when they share a room in a facility and both request Medicaid to pay for cost of care.

B. Establish Financial Eligibility (STEP I)

The a/b must be financially eligible for Medicaid in order to receive help with cost of care. There are several different ways to establish financial eligibility. These are explained in items 1-4 beginning with the most frequently used method. A person only has to qualify under one of the methods. Use DHB- 5008, SUPPLEMENT B, as a guide. Financial eligibility (Step I) is already established for SSI Medicaid beneficiaries. Refer to MA- 1100, SSI Medicaid- County DSS Responsibility.

1. Nursing Facility's Medicaid Reimbursement Rate (DHB-5008, SUPPLEMENT B, Step I., A.)

Each facility has an assigned Medicaid reimbursement daily rate based Docusign Envelope ID: 950E9248-29CC-8930-81BC-BCEC667EB493