§ 6100.686. Room and board rate.
(a) If the actual provider room and board cost as specified in § 6100.684 (relating to actual provider room and board cost), less any benefits as specified in § 6100.685 (relating to benefits), is more than 72% of the SSI maximum rate plus the Pennsylvania supplement, the following criteria shall be used to establish the room and board rate:
(1) An individual’s share of room and board may not exceed 72% of the SSI maximum rate plus the Pennsylvania supplement.
(2) The proration of board costs shall occur after an individual is on leave from the residence for a consecutive period of 8 days or more. This proration may occur monthly, quarterly or semiannually as long as there is a record of the board costs that were returned to the individual.
(b) If an individual has earned wages, personal income from inheritance, Social Security or other types of income, the provider may not assess the room and board cost for the individual in excess of 72% of the SSI maximum rate plus the Pennsylvania supplement.
(c) If available income for an individual is less than the SSI maximum rate, the provider shall charge 72% of the individual’s available monthly income as the individual’s monthly obligation for room and board.
(d) An individual shall receive at least the monthly amount as established by the Social Security Administration related to the specific type of residential service location, for the individual’s personal needs allowance.
Cross References This section cited in 55 Pa. Code § 6100.681 (relating to room and board applicability); 55 Pa. Code § 6100.802 (relating to support coordination, targeted support management and base-funding support coordination); 55 Pa. Code § 6100.803 (relating to organized health care delivery system); and 55 Pa. Code § 6100.804 (relating to base-funding).
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