Chapter 182-513 WAC

Last Update: 12/27/23

CLIENT NOT IN OWN HOME—INSTITUTIONAL MEDICAL

WAC Sections

HTMLPDF182-513-1100Definitions related to long-term services and supports (LTSS).
HTMLPDF182-513-1105Personal needs allowance (PNA) and room and board standards in a medical institution and alternate living facility (ALF).
HTMLPDF182-513-1110Presumptive eligibility (PE)—Long-term services and supports (LTSS) in a home setting authorized by home and community services (HCS).
HTMLPDF182-513-1200Long-term services and supports (LTSS) authorized under Washington apple health programs.
HTMLPDF182-513-1205Determining eligibility for noninstitutional coverage in an alternate living facility (ALF).
HTMLPDF182-513-1210Community first choice (CFC)—Overview.
HTMLPDF182-513-1215Community first choice (CFC)—Eligibility.
HTMLPDF182-513-1220Community first choice (CFC)—Spousal impoverishment protections for noninstitutional Washington apple health clients.
HTMLPDF182-513-1225Medicaid personal care (MPC).
HTMLPDF182-513-1230Program of all-inclusive care for the elderly (PACE).
HTMLPDF182-513-1235Roads to community living (RCL).
HTMLPDF182-513-1240The hospice program.
HTMLPDF182-513-1245Medically needy hospice program in a medical institution.
HTMLPDF182-513-1315General eligibility requirements for long-term care (LTC) programs.
HTMLPDF182-513-1316General eligibility requirements for long-term care (LTC) programs.
HTMLPDF182-513-1317Income and resource criteria for an institutionalized person.
HTMLPDF182-513-1318Income and resource criteria for home and community based (HCB) waiver programs and hospice.
HTMLPDF182-513-1319State-funded programs for noncitizens who are not eligible for a federally funded program.
HTMLPDF182-513-1320Determining institutional status for long-term care (LTC) services.
HTMLPDF182-513-1325Determining available income for an SSI-related single client for long-term care (LTC) services.
HTMLPDF182-513-1330Determining available income for legally married couples for long-term care (LTC) services.
HTMLPDF182-513-1340Determining excluded income for long-term care (LTC) services.
HTMLPDF182-513-1345Determining disregarded income for institutional or hospice services under the medically needy (MN) program.
HTMLPDF182-513-1350Defining the resource standard and determining resource eligibility for SSI-related long-term care (LTC) services.
HTMLPDF182-513-1355Allocating resources to a community spouse when determining resource eligibility for SSI-related long-term care services.
HTMLPDF182-513-1363Evaluating an asset transfer for clients applying for or receiving long-term care (LTC) services.
HTMLPDF182-513-1367Hardship waivers.
HTMLPDF182-513-1380Determining a client's financial participation in the cost of care for long-term care in a medical institution.
HTMLPDF182-513-1385Determining the community spouse monthly maintenance needs allowance and dependent allowance in post-eligibility treatment of income for long-term care (LTC) programs.
HTMLPDF182-513-1395Determining eligibility for institutional services for people living in a medical institution under the SSI-related medically needy program.
HTMLPDF182-513-1396People living in a fraternal, religious, or benevolent nursing facility.
HTMLPDF182-513-1397Treatment of entrance fees for people residing in a continuing care retirement community or a life care community.
HTMLPDF182-513-1400Long-term care (LTC) partnership program (index).
HTMLPDF182-513-1405Definitions.
HTMLPDF182-513-1410LTC partnership policy qualifications.
HTMLPDF182-513-1415Assets that can't be protected under the LTC partnership provisions.
HTMLPDF182-513-1420Eligibility for asset protection under a partnership policy.
HTMLPDF182-513-1425Not qualifying for LTC medicaid if an LTC partnership policy is in pay status.
HTMLPDF182-513-1430Change of circumstances that must be reported when there is an LTC partnership policy paying a portion of care.
HTMLPDF182-513-1435When Washington recognizes an LTC partnership policy purchased in another state.
HTMLPDF182-513-1440Determining how many of my assets can be protected.
HTMLPDF182-513-1445Designating a protected asset and required proof.
HTMLPDF182-513-1450How the transfer of assets affects LTC partnership and medicaid eligibility.
HTMLPDF182-513-1455What happens to protected assets under a LTC partnership policy after death.
HTMLPDF182-513-1530Maximum guardianship fee and related cost deductions allowed from a client's participation or room and board on or after June 1, 2018.
HTMLPDF182-513-1600Medicaid alternative care (MAC)—Overview.
HTMLPDF182-513-1605Medicaid alternative care (MAC)—Eligibility.
HTMLPDF182-513-1610Tailored supports for older adults (TSOA)—Overview.
HTMLPDF182-513-1615Tailored supports for older adults (TSOA)—General eligibility.
HTMLPDF182-513-1620Tailored supports for older adults (TSOA)—Presumptive eligibility (PE).
HTMLPDF182-513-1625Tailored supports for older adults (TSOA)—Applications.
HTMLPDF182-513-1630Tailored supports for older adults (TSOA)—Rights and responsibilities.
HTMLPDF182-513-1635Tailored supports for older adults (TSOA)—Income eligibility.
HTMLPDF182-513-1640Tailored supports for older adults (TSOA)—Resource eligibility.
HTMLPDF182-513-1645Tailored supports for older adults (TSOA)—Certification periods.
HTMLPDF182-513-1650Tailored supports for older adults (TSOA)—Changes of circumstances requirements.
HTMLPDF182-513-1655Tailored supports for older adults (TSOA)—Renewals.
HTMLPDF182-513-1660Medicaid alternative care (MAC) and tailored supports for older adults (TSOA)—Spousal impoverishment.
DISPOSITION OF SECTIONS FORMERLY CODIFIED IN THIS TITLE
182-513-1300Payment standard for persons in medical institutions. [WSR 13-01-017, recodified as § 182-513-1300, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. WSR 98-16-044, § 388-478-0040, filed 7/31/98, effective 9/1/98.] Repealed by WSR 17-03-116, filed 1/17/17, effective 2/17/17. Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155.
182-513-1301Definitions related to long-term care (LTC) services. [WSR 13-01-017, recodified as § 182-513-1301, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-513-1301, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 71A.12.030, 71A.10.020, chapters 71A.10 and 71A.12 RCW, 2004 c 276. WSR 04-18-054, § 388-513-1301, filed 8/27/04, effective 9/27/04. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.575. WSR 02-09-052, § 388-513-1301, filed 4/12/02, effective 5/13/02. Statutory Authority: RCW 11.92.180, 43.20B.460, 48.85.020, 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, 74.[09.]575, 74.09.585; 20 C.F.R. 416.1110-1112, 1123 and 1160; 42 C.F.R. 435.403 (j)(2) and 1005; and Sections 17, 1915(c), and 1924 (42 U.S.C. 1396) of the Social Security Act. WSR 00-01-051, § 388-513-1301, filed 12/8/99, effective 1/8/00.] Repealed by WSR 17-03-116, filed 1/17/17, effective 2/17/17. Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155.
182-513-1305Determining eligibility for noninstitutional medical assistance in an alternate living facility (ALF). [WSR 13-01-017, recodified as § 182-513-1305, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-513-1305, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 74.08.090. WSR 06-07-077, § 388-513-1305, filed 3/13/06, effective 4/13/06. Statutory Authority: RCW 11.92.180, 43.20B.460, 48.85.020, 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, 74.[09.]575, 74.09.585; 20 C.F.R. 416.1110-1112, 1123 and 1160; 42 C.F.R. 435.403 (j)(2) and 1005; and Sections 17, 1915(c), and 1924 (42 U.S.C. 1396) of the Social Security Act. WSR 00-01-051, § 388-513-1305, filed 12/8/99, effective 1/8/00. Statutory Authority: RCW 74.08.090 and 74.09.500. WSR 99-06-045, § 388-513-1305, filed 2/26/99, effective 3/29/99. Statutory Authority: RCW 74.08.090. WSR 94-10-065 (Order 3732), § 388-513-1305, filed 5/3/94, effective 6/3/94. Formerly parts of WAC 388-83-036 and 388-99-036.] Repealed by WSR 17-03-116, filed 1/17/17, effective 2/17/17. Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155.
182-513-1364Evaluating the transfer of an asset made on or after April 1, 2003 for long-term care (LTC) services. [WSR 13-01-017, recodified as § 182-513-1364, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-513-1364, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 34.05.353 (2)(d), 74.08.090, and chapters 74.09, 74.04 RCW. WSR 08-11-047, § 388-513-1364, filed 5/15/08, effective 6/15/08. Statutory Authority: RCW 74.08.090. WSR 03-20-059, § 388-513-1364, filed 9/26/03, effective 10/27/03. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.575. WSR 03-06-048, § 388-513-1364, filed 2/28/03, effective 4/1/03.] Repealed by WSR 17-03-116, filed 1/17/17, effective 2/17/17. Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155.
182-513-1365Evaluating the transfer of an asset made on or after March 1, 1997 and before April 1, 2003 for long-term care (LTC) services. [WSR 13-01-017, recodified as § 182-513-1365, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-513-1365, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 34.05.353 (2)(d), 74.08.090, and chapters 74.09, 74.04 RCW. WSR 08-11-047, § 388-513-1365, filed 5/15/08, effective 6/15/08. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.575. WSR 03-14-038, § 388-513-1365, filed 6/23/03, effective 8/1/03. Statutory Authority: RCW 74.08.090. WSR 01-02-076, § 388-513-1365, filed 12/29/00, effective 1/29/01. Statutory Authority: RCW 11.92.180, 43.20B.460, 48.85.020, 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, 74.[09.]575, 74.09.585; 20 C.F.R. 416.1110-1112, 1123 and 1160; 42 C.F.R. 435.403 (j)(2) and 1005; and Sections 17, 1915(c), and 1924 (42 U.S.C. 1396) of the Social Security Act. WSR 00-01-051, § 388-513-1365, filed 12/8/99, effective 1/8/00. Statutory Authority: RCW 74.08.090 and 74.09.500. WSR 99-06-045, § 388-513-1365, filed 2/26/99, effective 3/29/99. Statutory Authority: RCW 74.08.090, 74.04.050, 74.04.057, 74.09.585 and § 17 of the Social Security Act. WSR 97-05-040, § 388-513-1365, filed 2/14/97, effective 3/17/97. Statutory Authority: RCW 74.08.090. WSR 95-02-027 (Order 3818), § 388-513-1365, filed 12/28/94, effective 1/28/95; WSR 94-10-065 (Order 3732), § 388-513-1365, filed 5/3/94, effective 6/3/94. Formerly WAC 388-95-395.] Repealed by WSR 17-03-116, filed 1/17/17, effective 2/17/17. Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155.
182-513-1366Evaluating the transfer of an asset made before March 1, 1997 for long-term care (LTC) services. [WSR 13-01-017, recodified as § 182-513-1366, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 11.92.180, 43.20B.460, 48.85.020, 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, 74.[09.]575, 74.09.585; 20 C.F.R. 416.1110-1112, 1123 and 1160; 42 C.F.R. 435.403 (j)(2) and 1005; and Sections 17, 1915(c), and 1924 (42 U.S.C. 1396) of the Social Security Act. WSR 00-01-051, § 388-513-1366, filed 12/8/99, effective 1/8/00.] Repealed by WSR 17-03-116, filed 1/17/17, effective 2/17/17. Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155.
182-513-1500Payment standard for persons in certain group living facilities. [WSR 13-01-017, recodified as § 182-513-1500, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. WSR 98-16-044, § 388-478-0045, filed 7/31/98, effective 9/1/98.] Decodified by WSR 13-03-096, filed 1/15/13, effective 1/15/13. Recodified as § 182-515-1500.
182-513-1505Purpose. [WSR 16-15-042, recodified as § 182-513-1505, filed 7/14/16, effective 7/14/16. Statutory Authority: RCW 11.92.180, 43.20B.460. WSR 03-16-022, § 388-79-010, filed 7/28/03, effective 8/28/03; WSR 98-10-055, § 388-79-010, filed 4/30/98, effective 5/31/98.] Repealed by WSR 18-10-024, filed 4/24/18, effective 6/1/18. Statutory Authority: RCW 41.05.021 and 41.05.160.
182-513-1510Definitions. [WSR 16-15-042, recodified as § 182-513-1510, filed 7/14/16, effective 7/14/16. Statutory Authority: RCW 11.92.180, 43.20B.460. WSR 03-16-022, § 388-79-020, filed 7/28/03, effective 8/28/03; WSR 98-10-055, § 388-79-020, filed 4/30/98, effective 5/31/98.] Repealed by WSR 18-10-024, filed 4/24/18, effective 6/1/18. Statutory Authority: RCW 41.05.021 and 41.05.160.
182-513-1515Maximum guardianship fees and related costs before June 1, 2018. [Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-10-024, § 182-513-1515, filed 4/24/18, effective 6/1/18. WSR 16-15-042, recodified as § 182-513-1515, filed 7/14/16, effective 7/14/16. Statutory Authority: RCW 11.92.180, 43.20B.460. WSR 03-16-022, § 388-79-030, filed 7/28/03, effective 8/28/03; WSR 98-10-055, § 388-79-030, filed 4/30/98, effective 5/31/98.] Decodified by WSR 18-11-039, filed 5/8/18, effective 6/1/18. Recodified as § 388-79A-010.
182-513-1520Procedure to revise award letter after June 15, 1998, but before September 1, 2003. [WSR 16-15-042, recodified as § 182-513-1520, filed 7/14/16, effective 7/14/16. Statutory Authority: RCW 11.92.180, 43.20B.460. WSR 03-16-022, § 388-79-040, filed 7/28/03, effective 8/28/03; WSR 98-10-055, § 388-79-040, filed 4/30/98, effective 5/31/98.] Repealed by WSR 18-10-024, filed 4/24/18, effective 6/1/18. Statutory Authority: RCW 41.05.021 and 41.05.160.
182-513-1525Procedure for allowing guardianship fees and related costs from client participation before June 1, 2018. [Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-10-024, § 182-513-1525, filed 4/24/18, effective 6/1/18. WSR 16-15-042, recodified as § 182-513-1525, filed 7/14/16, effective 7/14/16. Statutory Authority: RCW 11.92.180, 43.20B.460. WSR 03-16-022, § 388-79-050, filed 7/28/03, effective 8/28/03.] Decodified by WSR 18-11-039, filed 5/8/18, effective 6/1/18. Recodified as § 388-79A-015.