Title 017 | Chapter 003 | Regulation 020
PREVIOUS VERSION
The previous document that this document is based upon is available.
17 KAR 3:020.Charges for room and board, goods, and services at state veterans' nursing homes.
Section 1.
Definitions.(1)
"Ancillary services" means services for which a separate charge is customarily made. Ancillary services include, for example, physical therapy, occupational therapy, speech therapy, laboratory procedures, x-ray services, oxygen services, optometry services, podiatry services, dentist services, audiology services, and pharmacy goods and services.(2)
"Non-routine goods or services" mean those that are directly identifiable with an individual resident and which are not customarily intended for use by all residents including such things as transportation, special activities, cable television services, pay-per-view channels, private or personal phone service, hospitalization, ambulance services, hearing aids, dentures, cosmetology or beautician services (other than basic haircuts), orthotic devices, and specialty care and equipment.(3)
"Nursing facility" means a state veterans' home (SVH) operated by the Kentucky Department of Veterans Affairs.(4)
"Private pay" means residents who pay for their nursing home care out of personal funds.(5)
"Private room" means a room in a state veterans' home that was not built in accordance with the federal VA's community living center or small house design requirements, VHA Handbook, Section 1142.01, or Small House Model design guide, and does not have a roommate.(6)
"Resident" means a Kentucky veteran admitted to a state veterans' nursing facility.(7)
"Room and board" means the room, dietary services, social services, nursing services, basic laundry services, the use of equipment and facilities, and routine medical and surgical supplies.(8)
"Routine goods or services" mean those which are not identifiable to a particular individual resident, but which are used by all residents.(9)
"Semi-private room" means a room in a state veterans' home that was not built in accordance with the federal VA's community living center or small house design requirements, VHA Handbook, Section 1142.01, or Small House Model design guide, and does have a roommate.(10)
"Suite" means a private suite with a private bathroom including a shower that was built in accordance with the federal VA's community living center or small house design requirements, VHA Handbook, Section 1142.01, or Small House Model design guide.Section 2.
Charges at State Veterans Nursing Homes.(1)
(a)
The private pay rate for room and board at a state veterans' nursing facility shall be established by each facility based on the total cost of care, community rates, and available revenue sources.(b)
Any change to a facility's charges for room and board, goods, or services shall require advance notification in accordance with 42 C.F.R. Part 483, Subpart B– 483.10(g)(18)(ii).(c)
There shall be a separate and distinct charge for a semi-private room, a private room, and a suite.(2)
The total monthly charge for a private pay resident shall be:(a)
The applicable private pay rate for room and board;(b)
Any charge for non-routine goods or services; and(c)
Any charge for ancillary services.Section 3.
Computation of Room and Board Charges.(1)
The monthly charge for a Medicaid qualified resident shall be established by the Kentucky Department of Medicaid services in accordancewith 907 KAR 1:006. All items and services considered by the Medicaid program to be non-covered as defined in 907 KAR 1:022, that were provided to Medicaid residents during any period of a covered stay, may be billed to the resident or another payer.(2)
If a veteran meets the requirements established in 38 U.S.C. 1745(a) for a service-connected disability, the veteran shall not be charged for any room and board, goods, or services.(3)
The monthly charge for a Medicare recipient qualifying for skilled services shall be the applicable co-payments as established by the Centers for Medicare and Medicaid services in 42 C.F.R. Part 413.(4)
A late fee of six (6) percent per annum may be assessed on any unpaid balances.Section 4.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
U.S. Department of Veterans Affairs, "VHA Handbook, Section 1142.01", August 13, 2008; and(b)
U.S. Department of Veterans Affairs, "Small House Model design guide", January 2017.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of Kentucky Veterans Centers, Kentucky Department of Veterans Affairs, 1111B Louisville Road, Frankfort, Kentucky 40601, Monday through Friday, 8:00 a.m. to 4:30 p.m. This material is also available on the U.S. Department of Veterans Affairs Web site at https://www.va.gov/vhapublications/index.cfm.HISTORY: (33 Ky.R. 1466; Am. 1787; eff. 2-2-2007; 35 Ky.R. 11; 611; eff. 12-4-2008; 38 Ky.R. 1460; eff. 5-4-2012; 44 Ky.R. 548, 902; eff. 12-1-2017; Cert eff. 8-7-2020; 49 Ky.R. 1469, 1898; eff. 6-21-2023.)
FILED WITH LRC: March 7, 2023
CONTACT PERSON: Tamara Reid-McIntosh, Esq., Executive Director & Counsel, Office of Veteran Legal Services, 1111 Louisville Rd., Suite B, Frankfort, Kentucky 40601; phone (502) 782.5723; fax (502) 564.9240; email tamara.reidmcintosh@ky.gov.
17 KAR 3:020.Charges for room and board, goods, and services at state veterans' nursing homes.
Section 1.
Definitions.(1)
"Ancillary services" means services for which a separate charge is customarily made. Ancillary services include, for example, physical therapy, occupational therapy, speech therapy, laboratory procedures, x-ray services, oxygen services, optometry services, podiatry services, dentist services, audiology services, and pharmacy goods and services.(2)
"Non-routine goods or services" mean those that are directly identifiable with an individual resident and which are not customarily intended for use by all residents including such things as transportation, special activities, cable television services, pay-per-view channels, private or personal phone service, hospitalization, ambulance services, hearing aids, dentures, cosmetology or beautician services (other than basic haircuts), orthotic devices, and specialty care and equipment.(3)
"Nursing facility" means a state veterans' home (SVH) operated by the Kentucky Department of Veterans Affairs.(4)
"Private pay" means residents who pay for their nursing home care out of personal funds.(5)
"Private room" means a room in a state veterans' home that was not built in accordance with the federal VA's community living center or small house design requirements, VHA Handbook, Section 1142.01, or Small House Model design guide, and does not have a roommate.(6)
"Resident" means a Kentucky veteran admitted to a state veterans' nursing facility.(7)
"Room and board" means the room, dietary services, social services, nursing services, basic laundry services, the use of equipment and facilities, and routine medical and surgical supplies.(8)
"Routine goods or services" mean those which are not identifiable to a particular individual resident,(9)
"Semi-private room" means a room in a state veterans' home that was not built in accordance with the federal VA's community living center or small house design requirements, VHA Handbook, Section(10)
"Suite" means a private suite with a private bathroom including a shower that was built in accordanceSection 2.
Charges at State Veterans Nursing Homes.(1)
(a)
The private pay rate for room and board at a state veterans' nursing facility shall be established by each facility based on the total cost of care, community rates, and available revenue sources.(b)
Any change to a facility's charges for room and board, goods, or(c)
There shall(a)
(b)
(c)
(2)
The total monthly charge for a private pay resident shall be:(a)
The applicable private pay rate for room and board;(b)
Any charge for non-routine goods or services; and(c)
Any charge for ancillary services.Section 3.
Computation of Room and Board Charges.(1)
The monthly charge(2)
If a veteran meets the requirements established in 38 U.S.C. 1745(a) for a service-connected disability, the veteran shall not be charged for any room and board, goods, or services.(3)
(3)
(4)
The monthly charge for a Medicare recipient qualifying for skilled services shall be the applicable co-payments as established by the Centers for Medicare and Medicaid services in 42 C.F.R. Part 413.(4)(5)
A late fee of six (6) percent per annum may be assessed on any unpaid balances.Section 4.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
U.S. Department of Veterans Affairs, "VHA Handbook, Section 1142.01", August 13, 2008; and(b)
U.S. Department of Veterans Affairs, "Small House Model design guide", January 2017.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Office of Kentucky Veterans Centers, Kentucky Department of Veterans Affairs, 1111B Louisville Road, Frankfort, Kentucky 40601, Monday through Friday, 8:00 a.m. to 4:30 p.m. This material is also available on the U.S. Department of Veterans Affairs Web site at https://www.va.gov/vhapublications/index.cfm.HISTORY: (33 Ky.R. 1466; Am. 1787; eff. 2-2-2007; 35 Ky.R. 11; 611; eff. 12-4-2008; 38 Ky.R. 1460; eff. 5-4-2012; 44 Ky.R. 548, 902; eff. 12-1-2017; Cert eff. 8-7-2020; 49 Ky.R. 1469, 1898; eff. 6-21-2023.)
FILED WITH LRC: March 7, 2023
CONTACT PERSON: Tamara Reid-McIntosh, Esq., Executive Director & Counsel, Office of Veteran Legal Services, 1111 Louisville Rd., Suite B, Frankfort, Kentucky 40601; phone (502) 782.5723; fax (502) 564.9240; email tamara.reidmcintosh@ky.gov.