55-12.006. Residents' Contribution to Cost of Care

(1) Every resident who receives income from any source shall contribute to his or her cost of care while a resident of the home in accordance with Section 296.37, F.S., under the parameters set forth by the Florida Legislature.

(a) Income from any source is income over which the resident has control and can exercise discretion. It is gross income not including taxes or other expenses necessary for the production of the income.

(b) Pension, compensation or gratuity from the United States Government is the amount paid to the resident as a single person. Additional amounts paid for the support of a spouse or other dependents are not considered.

(c) A resident’s income shall be calculated to include all income from any source, plus any pension, compensation or gratuity from the United States Government, in accordance with Section 296.37, F.S. Upon the recommendation of the Administrator, and with the approval of the Director, a resident will be allowed to retain some additional amount on a temporary basis, when necessary due to exceptional or unusual personal health needs of the resident.

(2) The Administrator shall determine the amount of the required contribution of each resident of the home based on the daily cost of care in the home.

(a) The daily cost of care is calculated by dividing the total operating budget of the home for the period for which the calculation is being made by the estimated total number of days in the period that residents will occupy beds in the home (average daily census).

(b) The daily cost of care will be calculated annually based on the 12 month state fiscal year (July 1 through June 30), except that if the average daily census changes by 10%, up or down, for the immediately preceding 3 calendar month period, the Administrator may recalculate the daily cost of care based on the revised daily census figure.

(c) The residents required contribution shall be adjusted, up or down, on the first day of the month following the month in which the recalculation of the daily cost of care occurs.

(3) The United States Department of Veterans Affairs (VA) contribution is the amount of VA per diem payment to the home for those residents determined by the VA to be eligible to receive such assistance.

(4)(a) The required contribution for a resident who is eligible for the VA contribution is the daily cost of care as calculated under paragraph (2)(a), herein, not to exceed the amount of the resident’s income as calculated under paragraph (1)(c), herein.

(b) The required contribution for a resident who is not eligible for the VA contribution is the daily cost of care as calculated under paragraph (2)(a), herein.

(5) Upon admission the resident shall pay in full, in advance, the pro-rata share of the resident’s contribution for the remainder of the calendar month during which the resident is admitted.

(6) Each resident shall pay the full amount of the resident’s contribution for each calendar month, in advance, by the fifth business day of the month. In the event the resident is discharged for any reason before the end of the month, a pro-rata portion of the resident’s contribution for the month shall be refunded to the resident.

(7) Failure to pay the required contribution will be cause for the Administrator, subject to the approval of the Director, to dismiss the resident from the home.

(8) This rule will expire unless re-adopted no later than five years from the effective date.

Rulemaking Authority 296.34(3) FS. Law Implemented 296.37 FS. History–New 5-23-93, Amended 12-27-98, 7-26-00, 6-10-08, 11-27-22.