16 Del. Admin. Code § 20000-20640
The patient pay amount equals total gross income minus all protected amounts and disregards.
The fiscal agent will compute the payment to the Nursing Facility for each recipient by multiplying the established per diem rate by the number of days of nursing facility care received in a month and deducting the patient pay amount.
The per diem rate is established by DSS through an evaluation of nursing facilities' cost reports.
If vendor payment is made to the nursing facility for part of the month, a Patient Pay Calculation must be done to prorate the patient pay amount for that month.
For example: If a patient normally would be expected to pay $120.00 toward his care in a nursing facility for a full month, but enters the home on the 21st day of June, (10 days remaining in the month), his patient pay amount for that month would be $40.00 (see calculation below).
Patient pay divided by # of days in month = per diem
$120.00 divided by 30 = $4.00
Per Diem x # of days in facility = prorated patient pay
$4.00 x 10 = $40.00
16 Del. Admin. Code § 20000-20640