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Residential Care Facility (RCF) First Month Client Participation - Iowa

When a client lived at home for part of the month of entry to a facility, the SSI Federal Benefit Rate (FBR) for one person or a married couple (if the recipient had a spouse living in the home in the month of entry) is deducted from the client’s countable income for that month.

The income that recipients of State Supplementary Assistance or Medicaid used in that month to pay for the cost of care is also not used when the care was received in a:

·           Family-life home

·           In-home health-related care provider

·           Medicaid Home-based or community-based waiver setting

·           Medical institution

·           Another RCF

The income of a client is used for client participation beginning with the month of approval in the following circumstances:

·           The recipient left the facility for hospitalization or nursing care, then later returned to the RCF. If the recipient returns directly to the RCF, there is no break in client participation. If the recipient is discharged from the RCF and goes home before returning to the facility, the first month client participation is determined as though the recipient was entering the RCF from an independent living arrangement.

·           When the recipient transferred from nursing care to RCF care, or from one RCF to another, any unused client participation is applied toward the cost of care in the new facility.

·           The recipient changed from private-pay status to State Supplementary Assistance status while living in an RCF.

·           The recipient moved from an independent living arrangement to an RCF. These residents may keep enough of the first month’s income to meet maintenance or living expenses from the previous living arrangement, but any amount that is over the SSI standard for the household’s previous living arrangement is not disregarded.

Also see:

·     Residential Care Facility Assistance Client Participation.

·           Residential Care Facility Assistance Income Limits

·           Residential Care Facility Resource and Income Guidelines for Married Couples

·           Nonfinancial Eligibility for Residential Care Facility (RCF) Assistance

·           Resource and Income Guidelines for Residential Care Facility (RCF) Assistance

·           Overview of Iowa's State Administered State Supplementary Assistance Programs.

·           Overview of Benefits in Iowa

Source: DHS Employees’ Policy Manual

Title 6, Other Income Maintenance (IM) Programs

·     Chapter B, State Supplemental Assistance, Residential Care Facility Assistance, Client Participation, pages 67-68.

Regulation citations: 441 IAC 52.1(3)"a" (6)

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