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Calculating Income And Converting To Monthly Amount
1. Paid weekly - Multiply gross income by 4.3 for monthly amount.
2. Paid bi-weekly - Multiply gross income by 2.15 for monthly amount.
3. Paid semi-monthly - Multiply gross income by 2 for monthly amount.
Allow applicants to anticipate income on a month-to-month basis rather than using the 4.3, 2.15, or 2 conversions, when advantageous to the assistance unit.
Determining Patient Contribution
1. Prorate the patient contribution when a client resides in nursing home for a partial month.
Example:
Prorating Income
Client enters nursing home on 3/19.
Monthly income is $1307.90.
$1307.90 - $304.90 (allowable deductions) divided by 31 days = $32.25 x 9 days = $291.15 patient contribution.
2. Calculate the patient contribution when an individual has a long term care insurance policy in the following manner:
Example:
Long Term Care Insurance Policy
Example 1
STEP 1
Nursing Home Daily Rate: $143.10
Times # of days in month x 30
Total monthly Medicaid rate $4,293.00
LTC insurance payment $140.00
Times # of days in month x 30
Total monthly LTC Insurance payment - $4,200.00
Subtract monthly Medicaid rate from the monthly LTC Insurance payment
Total Amount Owed to Facility $ 93.00
STEP 2
Clients Gross Income: $400.00
Minus Allowable deductions: - $ 50.00
Clients Countable income $ 350.00
STEP 3 Patient Contribution
Patient contribution is $93.00
The patient contribution will be whichever is less, the total amount owed to the facility or the client’s countable income after deductions.
Example 2
STEP 1 – Total Amount Owed to Facility
Nursing Home Daily Rate: $187.00
Times # of days in month x 31
Total monthly Medicaid rate $5,797.00
LTC insurance payment $125.00
Times # of days in month x 31
Total monthly LTC Insurance payment - $3,875.00
Subtract monthly Medicaid rate from the monthly LTC Insurance payment
Total Amount Owed to Facility $1,922.00
STEP 2 Client’s Countable Income
Clients Gross Income: $600.00
Allowable Deductions: - $ 50.00
Clients Countable Income $ 550.00
STEP 3 Patient Contribution
Patient contribution is $550.00
* The patient contribution will be whichever is less, the total amount owed to the facility or the client’s countable income after deductions.