Fla. Admin. Code Ann. R. 55-12.006 - Residents' Contribution to Cost of Care
(1) Every
resident who receives income from any source shall contribute to his or her
cost of care while a resident of the home in accordance with Section 296.37,
F.S., under the parameters set forth by the Florida Legislature.
(a) Income from any source is income over
which the resident has control and can exercise discretion. It is gross income
not including taxes or other expenses necessary for the production of the
income.
(b) Pension, compensation
or gratuity from the United States Government is the amount paid to the
resident as a single person. Additional amounts paid for the support of a
spouse or other dependents are not considered.
(c) A resident's income shall be calculated
to include all income from any source, plus any pension, compensation or
gratuity from the United States Government, in accordance with Section 296.37,
F.S. Upon the recommendation of the Administrator, and with the approval of the
Director, a resident will be allowed to retain some additional amount on a
temporary basis, when necessary due to exceptional or unusual personal health
needs of the resident.
(2) The Administrator shall determine the
amount of the required contribution of each resident of the home based on the
daily cost of care in the home.
(a) The daily
cost of care is calculated by dividing the total operating budget of the home
for the period for which the calculation is being made by the estimated total
number of days in the period that residents will occupy beds in the home
(average daily census).
(b) The
daily cost of care will be calculated annually based on the 12 month state
fiscal year (July 1 through June 30), except that if the average daily census
changes by 10%, up or down, for the immediately preceding 3 calendar month
period, the Administrator may recalculate the daily cost of care based on the
revised daily census figure.
(c)
The residents required contribution shall be adjusted, up or down, on the first
day of the month following the month in which the recalculation of the daily
cost of care occurs.
(3)
The United States Department of Veterans Affairs (VA) contribution is the
amount of VA per diem payment to the home for those residents determined by the
VA to be eligible to receive such assistance.
(4)
(a) The
required contribution for a resident who is eligible for the VA contribution is
the daily cost of care as calculated under paragraph (2)(a), herein, not to
exceed the amount of the resident's income as calculated under paragraph
(1)(c), herein.
(b) The required
contribution for a resident who is not eligible for the VA contribution is the
daily cost of care as calculated under paragraph (2)(a),
herein.
(5) Upon
admission the resident shall pay in full, in advance, the pro-rata share of the
resident's contribution for the remainder of the calendar month during which
the resident is admitted.
(6) Each
resident shall pay the full amount of the resident's contribution for each
calendar month, in advance, by the fifth business day of the month. In the
event the resident is discharged for any reason before the end of the month, a
pro-rata portion of the resident's contribution for the month shall be refunded
to the resident.
(7) Failure to pay
the required contribution will be cause for the Administrator, subject to the
approval of the Director, to dismiss the resident from the home.
(8) This rule will expire unless re-adopted
no later than five years from the effective date.
Notes
Rulemaking Authority 296.34(3) FS. Law Implemented 296.37 FS.
New 5-23-93, Amended 12-27-98, 7-26-00, 6-10-08, 11-27-22.
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