1. (a) The nursing facility cap shall be 300% of the maximum SSI benefit for an eligible individual as determined in accordance with 20 CFR 416.410, adjusted by cost-of-living increases pursuant to 20 CFR 416.405.
2. (b) The individual shall be income eligible for nursing facility care as categorically needy when the individual’s monthly gross income, as defined in He-W 601.04(o), is less than or equal to the nursing facility cap specified in (a) above.

3. (c) The individual shall be income eligible for nursing facility care as medically needy when:

   1. (1) The individual's monthly gross income, as defined in He-W 601.04(o), exceeds the nursing facility cap specified in (a) above; and
   2. (2) The individual’s net income, as defined in He-W 601.05(v), is less than or equal to the monthly medicaid nursing facility rate, as defined in He-E 806.01(aa).
4. (d) When determining resource eligibility for nursing facility care as categorically needy, $1,000 of the individual’s resources shall be disregarded.

Source. (See Revision Note #1 at Chapter Heading He-W 600) #5171, eff 6-26-91; ss by #5316, eff 1-27-92; ss by #5561, eff 1-22-93; ss by #5790, eff 2-22-94; ss by #5966, eff 1-27-95; amd by #6969, eff 4-1-99; ss by #7824, eff 2-8-03; ss by #9289, eff 10-3-08; ss by #12050, eff 11-19-16 (See Revision Note #2 at Part heading for He-W 858)