New Mexico Administrative Code › Title 7 - HEALTH › Chapter 25 - STATE HEALTH INSTITUTIONS › Part 10 - NEW MEXICO VETERANS CENTER POLICY › Section 7.25.10.15 - CARE AND MAINTENANCE CHARGES

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Purpose: To establish policy and procedures relating to the scope and care
				offered and the maintenance charges for service.
B. Background: Although the state of New
				Mexico and the veterans administration pay for the majority of costs of care,
				it is necessary for the center to charge residents for services in order to
				provide the full range of services offered. These charges shall be based upon
				total income of the residents and based on their ability to pay.
C. Policy: It shall be the policy of the New
				Mexico veterans center, in accordance with the New Mexico Statutes Annotated,
				1978 Compilation, Section
				23-4-4, that:
(1) Patients of the New Mexico veterans
				center shall be assessed a monthly care and maintenance charge based upon the
				level of care provided to them and their individual ability to pay. The claim
				of the state for such care and treatment shall constitute a valid indebtedness
				against any such patient and his estate shall not be barred by any statute of
				limitations. At the death of the patient, this claim shall be allowed and paid
				as other lawful claims against the estate.
(2) Nursing care charge and scope of services
				provided:
(a) The charge for nursing care of
				patients shall be set by the veterans service commission.
(b) Nursing care shall include room and board
				in the nursing care section of the veterans center and the full range of
				medical and nursing services offered in-house at the center. Medical and
				nursing services shall minimally include: staff physician services,
				intermediate nursing care, all required medications and their administration,
				all necessary x-ray and laboratory services which are performed by the center,
				and all required therapy performed by the center. Nursing care does not include
				those medical or other services which a patient requires or receives beyond
				those provided within or by the center, personal discretionary use items, such
				as tobacco or the purchase or laundry of street clothes.
(3) Domiciliary care charge and scope of
				services provided:
(a) The charge for
				domiciliary care to patients shall be set by the veterans service
				commission.
(b) Domiciliary care
				shall include room and board in the domiciliary section of the veterans center
				and limited medical care services offered by the center. Medical services shall
				minimally include staff physician services, all required medications, all
				necessary x-ray and laboratory services which are performed by the center, and
				all required therapy performed by the center. Domiciliary care does not include
				intermediate nursing care, administration of medications, required medical or
				other services not performed by the center, personal discretionary use items,
				such as tobacco or the purchase or laundry of street clothes.
(4) Care and maintenance charge
				adjustments and exclusions:
(a) Care and
				maintenance charges shall be computed in a manner to maximize the veterans
				administration pension and compensation benefits to which the veteran is
				entitled.
(b) Care and maintenance
				charges shall be computed in a manner to assure that the veteran retains an
				equitable amount to be set by the veterans service commission.
(c) The care and maintenance charge shall not
				exceed three times the per diem paid by the veterans administration for the
				type of care provided.
(d) The
				ability or inability of a resident to pay the established rates shall not
				reflect adversely upon his admission to the center.
(e) Any patient of the New Mexico veterans
				center or his/her guardian may seek a reduction or waiver of care and
				maintenance charges for reasons of financial hardship by requesting a review of
				his/her case by the New Mexico veterans service commission. Requests for review
				of care and maintenance charges shall be submitted in writing to the center
				administrator or to the chairman of the veterans service commission and shall
				describe as fully as possible the reasons the patient is seeking relief and the
				extent of the relief from care and maintenance charges requested. Upon
				receiving a request for relief of care and maintenance charges from a patient,
				the veterans center administrator shall assist the veteran in preparing the
				formal request and shall conduct a thorough investigation of the circumstances.
				The request for relief, all pertinent information, and the recommendation of
				the center administrator shall then be forwarded to the chairman of the
				veterans service commission for submission to the veterans service commission
				for review and action.
(5) Other factors governing assessment and
				payment of care and maintenance charges:
(a)
				Care and maintenance charges begin on the first day of admission.
(b) Care and maintenance charges are to be
				paid on the first of each month or as soon thereafter as possible for the care
				and maintenance to be received in the following month.
(c) Any patient, his/her guardian, or legal
				spouse, who knowingly withholds or falsifies income or resource date or who
				withholds payment of assessed care and maintenance charges may subject the
				patient to discharge and forfeiture of benefits and may subject the patient, or
				other parties responsible, to legal action related to the recovery of valid
				indebtedness to the state of New Mexico.
(d) When a patient's veterans administration
				compensation and pension benefits have been reduced or stopped due to excessive
				resources or estate, a care and maintenance charge shall continue to be
				assessed at the level which would otherwise be indicated if the-patient was
				still entitled to receive full veterans administration compensation and
				benefits.
(e) Income will be
				rounded to the nearest whole dollar when computing care and maintenance
				charges, and the care and maintenance charges will be rounded to the nearest
				whole dollar when assessments are made.
(f) Patients on leave from the center for
				outside hospitalization or medical care shall not be charged for care and
				maintenance after their fourth day of absence. Patients on leave from the
				center for personal reasons of their own volition shall continue to be charged
				for care and maintenance for such period of their leave that their bed is being
				held open for them.