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Example #2: The case manager incorrectly allows a garnishment for back taxes as an income deduction and calculates the patient liability using net income after the garnishment. The mistake is discovered during a supervisory case review. Because the agency incorrectly calculated patient liability by allowing the deduction, do not adjust patient liability retroactively; adjust patient liability the next administratively possible month, allowing for adverse notice. d. Deceased customer o Notify the facility of the patient liability amount due for the month of death. The facility will collect only for charges actually incurred. Deposit any unused patient liability in the patient trust fund account. F-120.4 Notification of Patient Liability/Case Status Upon approval or when patient liability changes, the customer, authorized representative(s) and facility are notified on a Notice of Decision of the amount and effective date. When the customer moves from one facility to another, notify the facilities of the current case status and monthly patient liability if this information has not already been provided to them in or for that month. F-120.5 Patient Liability Budgeting Procedures – Form 2220–EM/A a. Determine the customer’s total gross countable monthly income. 1. Subtract income excluded in patient liability b. Subtract the following items from total monthly income in the following order: 1. Personal Needs Allowance a Deduct a $154 personal needs allowance (PNA) for each month of institutionalization. b Additional personal needs – Institutionalized individuals with no community spouse living in the home but with other dependent family members in the home are allowed an additional personal needs allowance based on household size. The additional personal needs amount is determined by subtracting the 1996 needs standard of $459 from the current TANF need standard for the household size. Note: this requires a NOMADS work around. 2. Community Spouse Monthly Income Allowance Income allocated to the community spouse for maintenance. This amount (if any) is determined by subtracting any of the community spouse’s income which is considered available (including need-based assistance like TANF, SSI, etc.), from the monthly maintenance allowance. DO NOT count VA UME as income considered available to the community spouse. F-120.3 LONG TERM CARE SERVICES Division of Social Services Medical Assistance Manual 08 Aug MTL 08/25 Effictive Date of Patient Liability