Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Room and Board


The state limits the amount that can be charged to OSS recipients and Medicaid ACS clients for room and board to the amount of SSI, which is $552 plus the maximum Optional State Supplement of $78.40, which equals $630.40, minus a $54 personal needs allowance (PNA), which equals $576.40. Licensed AFCHs are required to designate at least one of their beds for an individual receiving OSS.

Family supplementation--capped at twice the amount of the SSI/OSS combined payment for room and board--is allowed. The state does not limit room and board charges for private pay residents.

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