Wyo. Code R. 048-0014-1
Effective Date: 06/09/1993 to 02/04/2002
Rule Type: Superceded Rules & Regulations
Reference Number: 048.0014.1.06091993
Section 1. Authority. These rules are promulgated pursuant to W.S. 25-11-108.
Section 2. Purpose.
(a) These rules have been adopted to implement W.S. 25-11-101 through 25-11-108 to:
(i) Establish uniform procedures for collection of charges from residents in Department of Health state institutions: Veterans' Home of Wyoming, Wyoming Pioneer Home, Wyoming Retirement Center, Wyoming State Hospital, and Wyoming State Training School.
(ii) Assess established charges based upon an ability to pay;
(iii) Determine persons legally responsible for payment of established charges;
(iv) Establish limitations on liability for established charges; and
(v) Establish penalties for giving false or misleading information in determining an ability to pay.
Section 3. Definitions. The definitions provided for in W.S. 25-11-101 as they currently appear or as amended, are incorporated herein by reference. Other applicable definitions are as follows:
(a) 'Agency' means the department which is administratively responsible for the respective state institution;
(b) 'Assets' means any resource from real or personal property owned by a person, or derived from the sale of real or personal property including:
(c) 'Facility' means any state institution listed in Title 25 of the Wyoming Statutes that are under the direct authority and control of the Department of Health or the Department of Family Services.
(d) 'Resident' means a patient or resident voluntarily admitted or involuntarily committed to a state institution.
(i) Liquid resources - cash, financial instruments, or other tangible property which can be payable on demand and converted into cash within twenty (20) workdays. Liquid resources include savings accounts, checking accounts, stocks, bonds, mutual funds, promissory notes, loans and mortgages;
(ii) Non-liquid resources - assets which are not cash or financial instruments and cannot be readily converted into cash within twenty (20) workdays;
(e) 'Available' means accessible, present or ready for immediate use by the resident at the time of or during the resident's stay at a state institution;
(f) “Average resident occupancy” means the average or mean daily resident census for all days during the fiscal year;
(g) “CAP” means the maximum amount of income and assets allowed as the threshold level for determining an established charge to be less than the actual cost;
(h) “Capital outlay” means an expenditure for long-term additions or improvements to a state institution as construction costs in building new rooms, remodeling existing facilities or purchasing major equipment;
(i) “Debt” means any form of legal indebtedness, liability or obligation to pay money by express agreement against the resident’s assets as mortgages, liens, loans, purchase contracts or security interests;
(j) “Deduction” means an allowance that may be subtracted from the legally responsible person’s income in determining an ability to pay;
(k) “Documentation” means placing a copy of the actual document or evidence in the resident’s record to verify any financial information;
(l) “Exemption” means an allowance that may be subtracted from the legally responsible person’s assets in determining an ability to pay;
(m) “Equity value” means the fair market value or the going rate for that item or property, less any legal debts against the item or property;
(n) “Financial instrument” means a formal or legal written document, including a negotiable instrument as defined in W.S. 34.1-3-104, and a security as defined in 34.1-8-102, or any other writing which evidences a right to the payment of money;
(o) “Hardship” means an undue, unanticipated or unexpected change in circumstances which results in adversity, suffering, deprivation or lack of means for a reasonable standard of living and that denotes an inability to pay;
(p) “Highest resident occupancy” means the highest daily resident census for all days during the fiscal year;
(q) “Income” means all cash, profits, wages or gains available to a person from any source, including but not limited to earnings, compensation for services as fees or commissions, self-employment, gross income derived from business, gains derived from dealings in property, rents, workers’ or unemployment compensation, child support, social security benefits, disability compensation, pensions, retirement benefits, interest, royalties, dividends, alimony and separate maintenance payments, annuities, income from life insurance and endowment contracts, veterans’ benefits, income from discharge of indebtedness, distributive share of partnership gross income, income from an interest in an estate or trust, or income in respect of a decedent;
“Indebtedness” means a sum of money due and owing for services rendered at a state institution;
(s) “Medicaid” means a program authorized by Title XIX of the Social Security Act, and the Wyoming Medical Assistance and Services Act in W.S. 42-4-101 through 42-4-112;
(t) “Minimum living allowance” means an allowance permitted to provide a reasonable standard of living for a resident, the resident’s spouse, parent or other legal dependents;
(u) “Personal property” means all things owned or possessed by a person excluding land and buildings;
(v) “Real property” means land, including houses, buildings or immovable objects attached permanently to the land;
(w) “Reasonable” means fair, just, moderate, suitable under the circumstances;
(x) “Retainage” means the amount of income and assets allowed to be kept by the resident for a reasonable standard of living and is the threshold level for determining an ability to pay established charges;
(y) “Services and treatment” means any help, use or benefit to a resident as a result of the work performed by the staff at a state institution, including but not limited to diagnosis, evaluation, medication, therapy or prescribed care, observation, supervision, discharge planning, rehabilitation, reformation, and custodial or domiciliary care. Services and treatment shall not include education provided to any person which is required by state or federal law;
(z) “Standard of living” means the minimum amount of money or other resources to purchase essential items necessary to sustain life and health, and to provide adequate housing, shelter and/or food, clothing and personal needs;
(aa) “Third party payor” means an entity which is under contract with the resident or legally responsible person to pay costs for medical, nursing home or other specified services and treatment; and
(bb) “Verification” means acquiring information or documents that prove a statement to be true.
(a) The agency shall be responsible for:
(i) Promulgating on or before October 1 of each year a schedule of actual costs for services and treatment at each state institution;
(ii) Establishing sliding scales for each state institution or related group of state institutions to determine established charges;
(iii) Establishing criteria for determining an ability to pay established charges, includ- ing assessing available income and assets and making allowances for a resident and the resident's spouse or other legal dependents to maintain a reasonable standard of living;
(iv) Designating any capital outlay, depreciable assets or real property repair and maintenance costs that are not to be included in determining actual costs;
(v) Establishing criteria for hardship cases which justify waiving collection or adjusting the established charge;
(vi) Designating an annual schedule for reviewing ability to pay;
(vii) Deciding which cases will be referred to a collection agency pursuant to W.S. 25-11-106(c) or to the attorney general's office for further proceedings against the resident's estate pursuant to W.S. 25-11-105(b); and
(viii) Establishing written policies and procedures for implementing these rules.
(a) The state institution shall be responsible for:
(i) Establishing daily rates or actual costs for services and treatment given to a resident. Actual costs shall be based on the actual care days delivered or on the highest resident occupancy for the prior fiscal year;
(ii) Determining the established charge each legally responsible person is to pay based on the applicable sliding scale;
(iii) Establishing specific deductions and exemptions in assessing ability to pay based upon the type of services and treatment given and needs of the resident;
(iv) Establishing a monthly billing system which provides at a minimum the daily established charge;
(v) Reviewing each resident's ability to pay per the applicable sliding scale;
(vi) Providing necessary information to third party payors for submitting payment of established charges;
(vii) Notifying legally responsible persons of established charges, liability for payment and agency actions in the event payment is not made;
(viii) Assessing circumstances for hardship cases which will be referred to the agency;
(ix) Providing information to the agency on unpaid established charges; and
(x) Establishing written policies and procedures necessary for the state institution to implement these rules.
(a) If a state institution is certified to care for Medicaid eligible residents or has residents who are receiving Medicaid assistance, the established charges shall not exceed the payment levels authorized by Medicaid. The state institutions shall only allow for deductions and exemptions as authorized by Medicaid in determining an ability to pay established charges;
(b) Any Medicaid restrictions or limitations placed on state institutions for certification purposes shall apply to these rules.
(a) When a resident is voluntarily admitted or involuntarily committed to a state institution, the state institution shall advise the legally responsible person in writing prior to admission, at the time of admission or within fifteen (15) days after admission of the following:
(i) The obligation to pay pursuant to W.S. 25-11-101(a)(iii), 25-11-102(c) and 25-11-103;
(ii) The schedule of actual costs for services and treatment established by the agency pursuant to W.S. 25-11-102(a);
(iii) The established charge based on the applicable sliding scale and information on the completed financial questionnaire. If the financial questionnaire is not completed and submitted to the state institution within fifteen (15) days after the resident is admitted, the state institution shall send a separate notice of the established charge to the legally responsible person after receiving the financial questionnaire and setting an established charge;
(iv) Liability for payment and any applicable limitations as provided in W.S. 25-11-105;
(v) The right to request agency review of the established charge as provided in W.S. 25-11-103(b) or appeal the agency decision pursuant to the Wyoming Administrative Procedure Act in W.S. 16-3-107; and
(vi) Penalties for falsifying or misrepresenting any financial information.
(b) Upon the court vesting the legal custody of a child in the agency and ordering the legally responsible person to pay charges pursuant to W.S. 14-6-236, the state institution shall comply with the notice requirements stated in Section 7.(a);
(c) Whenever the initial established charge is revised after a resident has been admitted, the state institution shall notify the legally responsible person a minimum of thirty (30) days prior to the effective date of the revision. The notice shall also include the basis for the revision and the effective date.
(a) A legally responsible person's financial questionnaire and other personally identifiable information are confidential and will not be disclosed except as necessary to determine an ability to pay the established charge, to verify any disclosed financial information, or for use by the state agency in a contested case or other legal proceeding case which involves the resident or his legally responsible person;
(b) A legally responsible person shall have signed an authorized consent form prior to a state institution disclosing financial or other personally identifiable information, except as provided in section 8(a) of these rules and regulations.
(a) Institutional determination of established charges will be submitted to the Institution Superintendents for final approval and the following procedure should be utilized in determining the established charge:
(i) Complete a financial questionnaire, identifying all available income and assets, and any assets disposed of by the legally responsible person in the past two (2) years. The questionnaire shall be:
(A) Signed by the legally responsible person or his/her legal guardian or conservator under oath and subject to penalty of false swearing as set forth in to W.S. 6-5-303; and
(B) Submitted within forty-five (45) days of the resident's admission. If the financial questionnaire is not submitted within forty-five (45) days, the agency shall set the established charge as the actual cost until financial information becomes available;
(ii) Provide any documents required by the state institution for verifying any information stated on the financial questionnaire;
(iii) Request agency review within sixty (60) days of receiving the notice of the established charge if protesting the agency's determination of established charges;
(iv) Update the financial questionnaire on an annual basis; and
(v) Notify the state institution of any change in circumstances which affect a legally responsible person's available income and assets. The notice shall be submitted to the state institution within sixty (60) days of the changed financial status. If a legally responsible person fails to notify the state institution within the sixty (60) days, the agency may set the established charge as the actual cost.
(b) The legally responsible person may be exempt from the requirements stated in Section 9.(a) if the legally responsible person pays the actual costs for services and treatment set by the agency throughout the resident's admission to a state institution. If payment becomes overdue or the legally responsible person's financial status changes, the legally responsible person shall comply with the financial disclosure requirements;
(c) The state institution shall complete the following procedures in determining the established charge:
(i) Review the information stated in the financial questionnaire;
(ii) Verify any stated information by requesting copies of documents as necessary which shall be incorporated into the resident’s record;
(iii) Allow any applicable deductions for payments actually made by the legally responsible person including but not limited to:
(A) Federal and state withholding taxes;
(B) Social security taxes and/or other required retirement deductions;
(C) Union or employee association dues;
(D) Court ordered alimony and child support payments;
(iv) Allow minimum living allowances for:
(A) The resident’s personal support per the schedule established by the state institution; and
(B) The resident’s spouse, parent and other legal dependent’s supported in the home per the schedule established by the state institution;
(v) Allow any applicable exemptions based upon the resident’s needs and the state institution’s services. Exemptions may include but are not limited to:
(A) The first ten thousand dollars ($10,000.00) equity value of the legally responsible person’s (defined as resident or client) personal property unless the person is receiving Medicaid assistance or the state institution is Medicaid certified;
(B) A resident’s primary home when lived in by the resident and/or resident’s spouse or legal dependents;
(vi) Determine the legally responsible person’s ability to pay charges based on available income and assets, and on a sliding scale. The sliding scale shall designate the following ability to pay levels:
(A) The retainage threshold level, including any applicable deductions, minimum living allowances, and exemptions. If a legally responsible person’s income and assets are below the retainage threshold level, no charge will be established;
(B) The CAP threshold level with the following limitations:
(I) If a legally responsible person's income and assets are under the CAP threshold level, then the agency will determine an established charge to be lower than the actual cost. The exact percent will be designated by the applicable sliding scale;
(II) If a legally responsible person's income and assets are above the CAP threshold level, then the established charge will be the actual cost;
(vii) Obtain an assignment of benefits from the legally responsible person who has insurance coverage. Conditions and limitations of accepting assignment by the state institution may limit the established charge. Established charges shall be actual costs in the following situations:
(A) If a legally responsible person submits claims directly to the third party payor in lieu of assigning benefits to the state institution; or
(B) If the third party payor is obligated by law or contract to pay full actual costs for services provided to a resident admitted to a state institution;
(viii) Revise the established charge upon the annual promulgation of actual costs or if a change occurs in the legally responsible person's financial status;
(ix) Review the established charge and ability to pay on an annual basis; and
(x) Refer any payor's protest of the established charge to the agency in accordance with W.S. 25-11-103(b).
(a) An account shall be established for each resident which records the established charge, payments received, and the unpaid balance of established charges;
(b) Monthly billings shall be sent to the legally responsible person the month following either receipt of the completed financial questionnaire or forty-five (45) days after the resident's admission to a state institution. Charges shall be prorated from the date of admission to the last day of the month. The monthly billing shall include at a minimum the daily established charge and the total monthly balance due (for specific billing procedures, please refer to relevant policy for applicable state institutions);
(c) All payments received shall be recorded in the resident's account and reimbursed to the state general fund pursuant to W.S. 25-11104;
(d) If full payment is not received within thirty (30) days after mailing the monthly billing, the state institution shall send a notice to the legally responsible person that the payment is overdue. The notice shall also provide that the account may be referred to the agency for collection if payment is not received within ninety (90) days after the end of the month in which the charges accrue;
(e) If full payment is not received within ninety (90) days after the end of the month in which the charges accrue, the account is in arrears, and the state institution shall refer the account to the agency for collection. If a third party payor payment is pending, the state institution may refer only the difference between the third party payor payment and the unpaid established charge;
(f) If partial payment is received, the state institution shall carry forward the indebtedness according to the state accounting system. Any indebtedness shall be referred to the agency for collection pursuant to W.S. 25-11-106 if full payment is not received within ninety (90) days after the end of the month in which the charges accrue. The agency retains the right to seek full reimbursement of any unpaid established charges from the resident or other legally responsible persons, or from the resident's estate upon his death by filing a claim as provided in Section 11.(d);
(g) Any collection efforts by the agency shall comply with W.S. 9-1-415. If any unpaid established charges are collected, the agency shall complete the following procedures;
(i) Credit the resident's account for the amount collected; and
(ii) Prorate the amount collected if the established charges have accrued at more than one state institution.
(a) The legally responsible person shall be liable for paying all established charges for the entire duration of the resident's voluntary admission or involuntary commitment to a state institution; or
(i) If the legally responsible person is a parent or spouse, the parent or spouse shall only be liable for paying established charges up to two (2) years of cumulative care at the state institution. The two year limitation on a parent's or spouse's liability is subject to the following:
(A) Cumulative care shall include all services and treatment rendered by one or more state institutions for the same resident pursuant to:
(I) An involuntary commitment order or series of orders without releasing the resident but excludes a subsequent commitment if the resident was released from a state institution for a period of time and then recommitted to another state institution pursuant to a new or different involuntary commitment order; or
(II) A voluntary admission, and includes subsequent voluntary admissions at the same or another state institution; and
(B) The resident may be transferred from one state institution to another if the original involuntary commitment order remains in effect or if voluntarily admitted and transferred; and
(C) The parent or spouse as the legally responsible person is the same person throughout the resident's voluntary admission or involuntary commitment to one or more state institutions. If the legally responsible person changes during the resident's admission or commitment, each parent's or spouse's liability extends to a two (2) year period; and (D) If a parent or spouse is legally responsible for one or more residents whether or not at the same time, then each resident shall be considered separate from the other and have independent two year periods of cumulative care.
(b) The resident, his estate and other legally responsible persons shall be liable for paying any unpaid established charges during the resident's stay at a state institution, and after the resident is released. Liability for payment extends to the entire duration of the resident's stay at the state institution;
(c) The third party payor shall be liable to pay for services and treatment when obligated by law or contract, for the resident's entire stay at the state institution, as provided in W.S. 25-11-103(d) and 25-11105(a);
(d) The agency may file a claim against the resident's estate pursuant to W.S. 25-11-105(b) if a resident or a released resident dies. The state institution shall complete either of the following:
(i) An affidavit for collection of estate for estates estimated to be less than seventy thousand dollars ($70,000.00), including the following information:
(ii) A creditor's claim after the first public notice to creditors has been published, if the estate is estimated to be greater than seventy thousand dollars ($70,000.00). A creditor's claim shall include the following information:
(E) Balance owed to the state institution after payments received; (F) Executor of resident's estate, name and address; (G) All information relative to location of any assets including but not
limited to:
(I) Bank account numbers; (II) Address and value of property; and (III) Any mineral ownership;
(e) The agency may decide not to file a claim against the resident's estate after reviewing a written report submitted by the resident's legal dependents and estate beneficiaries explaining a need for support from the proceeds of the resident's estate.
Section 12. Discharge for Nonpayment for Services Rendered.
(a) A resident of a facility may be involuntarily discharged for nonpayment of established charges for services rendered by the facility. The facility shall provide a resident, his guardian or legally responsible person, whichever individual is appropriate, with at least thirty (30) days written notice of the facility's intent to begin steps necessary to involuntarily discharge the resident for failure to pay established charges for services rendered by the facility.
Section 13. Penalties for False Information.
(a) If a legally responsible person knowingly makes a false acknowledgement, declaration or statement in disclosing any information regarding the resident's income and assets on the financial questionnaire, the agency may file a petition with the state attorney general to initiate court proceedings pursuant to W.S. 6-5-303.
(b) Upon verifying a false acknowledgement, declaration or statement on the resident's financial questionnaire, the agency may take any of the following actions:
(i) Reevaluate the legally responsible person's financial status and ability to pay; (ii) Make any necessary adjustments in the established charges, including setting the established charge as the actual cost; and (iii) Seek reimbursement from the resident, his estate and other legally responsible persons for any unpaid established charges due to the state institution had the false statement not occurred.
(a) Criteria for determining an ability to pay established charges shall include the following:
(i) Deductions stated in Section 9.(c)(iii) shall be allowed and any others provided for in the state institution's sliding scale. The amount of income after all appropriate deductions is the net income;
(ii) Exemptions stated in Section 9.(c)(v) shall be allowed and any others provided for in the state institution's sliding scale. The amount of assets after all appropriate exemptions is the adjusted assets.
(iii) Minimum living allowances shall be subtracted from net income and/or adjusted assets prior to using any applicable sliding scale. The minimum living allowances provided for in Section 9.(c)(iv) are as follows:
(A) For an adult resident who has a limited/fixed income, is a long-term resident of a state institution, and has no other legal dependents to support:
Resident = $65 per month plus 15% of the monthly income
(B) For an adult resident who has a family to support or for a juvenile resident who is supported by a family:
Adult in the home: $450 per adult/per month
Children in college: $150 additional per child/per month Children in the home: per chart below
| Monthly Net Income | Number of Children in the Home | 1 | 2 | 3 | 4 | 5 | 6 |
|---|---|---|---|---|---|---|---|
| $ 1 - 500 | 12% | 20% | 25% | 30% | 35% | 40% | |
| $ 501 - 1000 | 17% | 25% | 30% | 32% | 37% | 42% | |
| $ 1001 - 1500 | 20% | 28% | 32% | 35% | 40% | 45% | |
| $ 1501 - 2000 | 22% | 29% | 32% | 40% | 40% | 45% | |
| $ 2001 - above | 26% | 30% | 33% | 40% | 40% | 45% |
(iv) The net income and the adjusted assets shall be utilized in determining a legally responsible person's ability to pay established charges. Established charges shall be computed by utilizing the following sliding scales:
(A) The sliding scale for adjusted assets provided for in Section 14.(a)(ii) or as otherwise provided by the state institution's applicable sliding scale; and
(B) The state institution's applicable sliding scale for net income provided for in Section 14.(a)(v), which follows;
(v) The state institution's sliding scales for determining the percentage of net income to be assessed as an established charge are as follows:
(A) The Wyoming State Hospital:
(I) In addition to those deductions provided for in Section 9.(c)(iii) for an adult resident who has a family to support or for a juvenile resident who is supported by a family, the following deductions shall be allowed:
(1.) Health and medical insurance; (2.) Day-care expenses if actually paid for by the legally responsible person; (3.) Business related expenses; (4.) Attorney, conservator, and/or guardian fees reasonably related to a resident's welfare and admission to a state institution; and (5.) Medical expenses not covered by third party payor if actually paid for by the legally responsible person.
(II) Sliding scale:
| Monthly Net Income longer | Percentage of Monthly Net Income as Established Charge | ||
|---|---|---|---|
| 1st 30 days | 2nd-5th | 6 months months or | |
| $1 - 249 | 30% | 15% | 7.5% |
| $ 250 - 499 | 35% | 20% | 10 % |
| $ 500 - 749 | 40% | 25% | 12.5% |
| $ 750 - 999 | 45% | 30% | 15 % |
| $ 1000 - 1499 | 50% | 35% | 17.5% |
| $ 1500 - 1999 | 55% | 40% | 20 % |
| $ 2000 - 2999 | 60% | 45% | 22.5% |
| $ 3000 - 3999 | 65% | 50% | 25 % |
| $ 4000 - above | Actual | Actual | Actual |
| Cost | Cost |
The following sliding scale may be used by the state institutions for determining the percentage of adjusted assets to be assessed as an established charge:
(III) Sliding scale:
Percent of Adjusted Assets by Length of Stay
| Step 1: | 1st 30 days | 2nd-5th 6 months | months or longer |
|---|---|---|---|
| Amount of Adjusted Assets | 2% | 1% | |
| ½% |
= Monthly Adjusted Assets
| Step 2: | ||
|---|---|---|
| Monthly Assets as Adjusted Assets Charge | Percent of Adjusted Established | |
| $ 0 - 500 | 20% | |
| $ 501 - 1000 | 30% | |
| $ 1001 - 1500 | 40% | |
| $ 1501 - 2000 | 50% | |
| $ 2001 - 2500 | 60% | |
| $ 2501 - above | 80% |
= Established Charge
(B) The Wyoming State Training School:
(I) In addition to those deductions provided for in Section 9.(c)(iii) for an adult resident who has a family to support or for a juvenile resident who is supported by a family, the following deductions shall be allowed:
(1.) Resident health insurance; and (2.) Medical expenses not covered by third party payor if actually paid by the legally responsible person.
(II) Clients living in non-ICF/MR certified units:
(1.) Actual costs shall be computed on a biennium budget expenditure, and shall reflect the minimum cost for providing treatment or services for a client. The actual cost shall be based on the prior biennium cost, excluding capital outlay and equipment costs.
(2.) All legally responsible persons who have assets in excess of ten thousand dollars ($10,000.00) and who use those resources to reasonably provide for their support in a residential facility, shall pay actual costs. The determination of whether assets exceed ten thousand dollars ($10,000.00) shall include any assets disposed of by the legally responsible person in the two (2) years prior to the date of application for admission.
(a) An additional amount may be exempted for whole life insurance, burial funds, or a combination of both, not to exceed a total of one thousand five hundred dollars ($1,500.00).
(3.) All legally responsible persons who have assets less than ten thousand dollars ($10,000.00) and who receive a limited/fixed income to provide for their support in a residential facility, shall pay a partial or established charge based on ability to pay. The established charge shall be the net income remaining after allowing the client to retain a minimum living allowance of sixty-five dollars ($65.00) plus fifteen percent (15%) of the monthly income.
(1.) Actual costs will be calculated in accordance with Wyoming Department of Health Medicaid Rules, Chapter XX, Reimbursement of Intermediate Care Facilities for the Mentally Retarded.
(IV) Established charges will be calculated in accordance with current Medicaid guidelines (reference Wyoming Department of Health Rules and Regulations for Collection of Charges, Chapter II, Section 6).
(I) Actual costs shall be computed on a biennium budget expenditure, and shall reflect the minimum cost for providing treatment or services for a resident. The actual cost shall be based on the prior biennium cost, excluding capital outlay and equipment costs, and actual collection for medications billed directly to the resident or other charges which are billed directly to the resident and which are accounted for as expenditure reimbursement reductions.
(II) All legally responsible persons who have assets in excess of ten thousand dollars ($10,000.00) and who use those resources to reasonably provide for their support in a residential facility, shall pay actual costs. The determination of whether assets exceed ten thousand dollars ($10,000.00) shall include any assets disposed of by the legally responsible person in the two (2) years prior to the date of application for admission.
(1.) An additional amount may be exempted for whole life insurance, burial funds, or a combination of both not to exceed a total of one thousand five hundred dollars ($1,500.00).
(III) All legally responsible persons who have assets less than ten thousand dollars ($10,000.00) and who receive a limited/fixed income to provide for their support in a residential facility, shall pay a partial or established charge based on ability to pay. The established charge shall be the net income remaining after allowing the resident to retain a minimum living allowance of sixty-five dollars ($65.00) plus fifteen percent (15%) of the monthly income.
(1.) The Director may approve a medical participation allowance for Medicare Part B insurance premiums and an additional amount which does not exceed the Medicare Part B monthly premium for supplemental health insurance premiums, and burial insurance not exceeding one thousand five hundred dollars ($1,500.00) in face value.
(I) Is a Medicaid certified nursing home based upon cost formula below. Refer to items (II) and (III).
(II) Actual costs will be compiled in accordance with the State of Wyoming Nursing Home Manual, Appendix E, “Medicaid Financial Reporting for Nursing Homes”.
(III) Established charges will be compiled in accordance with current Medicaid guidelines (Reference Wyoming Department of Health Rules and Regulations for Collection of Charges, Chapter II, Section 6).
(a) Institutional determination of uncollectible debts will be submitted to the Director.
(b) Pursuant to W.S. 9-1-415, all uncollectible debts must be certified by the State Auditor’s Office on the attached SA-25 Forms.