Minn. Stat. § 256S.19

Current through 2024, c. 127

Section 256S.19 - [See Note] MONTHLY CASE MIX BUDGET CAPS; NURSING FACILITY RESIDENTS

Subdivision 1.Requests for elderly waiver monthly conversion budget caps.

A participant who is a nursing facility resident when requesting an eligibility determination for elderly waiver services may request an elderly waiver monthly conversion budget cap for the cost of elderly waiver services.

Subd. 2.Eligibility for elderly waiver monthly conversion budget caps.

Only a participant discharged from a nursing facility after a minimum 30-day stay is eligible under this section for an elderly waiver monthly conversion budget cap.

Subd. 3.Calculation of monthly conversion budget caps.

(a) The elderly waiver monthly conversion budget cap for the cost of elderly waiver services must be based on the nursing facility case mix adjusted total payment rate of the nursing facility where the elderly waiver applicant currently resides for the applicant's case mix classification as determined according to section 256R.17.

(b) The elderly waiver monthly conversion budget cap for the cost of elderly waiver services must be calculated by multiplying the applicable nursing facility case mix adjusted total payment rate by 365, dividing by 12, and subtracting the participant's maintenance needs allowance.

(c) A participant's initially approved monthly conversion budget cap for elderly waiver services must be adjusted at least annually as described in section 256S.18, subdivision 5.

(d) Conversion budget caps for individuals participating in consumer-directed community supports must be set as described in paragraphs (a) to (c).

Subd. 4. [Deleted by 2023 amendment].

Minn. Stat. § 256S.19

Amended by 2023 Minn. Laws, ch. 61,s 2-43, eff. 7/1/2023 or upon federal approval, whichever is later.

Amended by 2023 Minn. Laws, ch. 61,s 2-15, eff. 1/1/2024 or upon federal approval, whichever is later.

Amended by 2020SP1 Minn. Laws, ch. 2,s 2-32, eff. 8/1/2020.

Added by 2019 Minn. Laws, ch. 54,s 1-19, eff. 8/1/2019.

This section is set out more than once due to postponed, multiple, or conflicting amendments.