N.D. Admin. Code 75-02-10-01

Current through Supplement No. 395, January, 2025
Section 75-02-10-01 - Definitions

The terms used in this chapter have the same meaning as in North Dakota Century Code chapter 50-24.5. In addition, for purposes of this chapter, unless the context requires otherwise:

1. "Activities of daily living" means bathing, dressing, toileting, transferring, eating, bed mobility, medication management, and personal hygiene.
2. "Basic care facility" means a residence, not licensed under North Dakota Century Code chapter 23-16 by the department, that provides room and board to five or more individuals who are not related by blood or marriage to the owner or manager of the residence and who, because of impaired capacity for independent living, require health, social, or personal care services, but do not require regular twenty-four-hour medical or nursing services and:
a. Makes response staff available at all times to meet the twenty-four-hour per day scheduled and unscheduled needs of the individual; or
b. Is kept, used, maintained, advertised, or held out to the public as an Alzheimer's, dementia, or special memory care facility.
3. "Countable income" means gross income reduced by:
a. The cost of guardianship or conservatorship fees actually charged, but no more than five percent of monthly gross income;
b. The cost of the Medicare premium, but only if the individual is ineligible for Medicare cost-sharing benefits described in subdivision a of subsection 19 of section 75-02-02.1-01 as a qualified Medicare beneficiary or a special low-income Medicare beneficiary;
c. Court-ordered child support payments actually paid on behalf of a minor child who is not a member of the individual's Medicaid unit; and
d. For individuals receiving benefits provided under subsection 1 or 2 of section 75-02-10-02:
(1) In the month the individual enters the facility, the medically needy income level for a family of the size of the family in which the individual was a member at the beginning of the month; and
(2) Sixty-five dollars plus one-half of the remaining monthly gross earned income.
4. "Gross income" includes any income at the disposal of an applicant, recipient, or responsible relative; any income with respect to which an applicant, recipient, or responsible relative has a legal interest in a liquidated sum and the legal ability to make the sum available for support or maintenance; or any income an applicant, recipient, or responsible relative has the lawful power to make available or to cause to be made available. It includes any income that would be applied in determining eligibility for benefits under 75-02-02.1; any income, except occasional small gifts, that would be disregarded in determining eligibility for benefits under 75-02-02.1, and recovery rebates authorized by section 2201 of the federal Coronavirus Aid, Relief, and Economic Security Act of 2020 [ Pub. L. 116-136 ]; annuities, pensions, retirement, and disability benefits to which an applicant or recipient, or spouse of an applicant or recipient, may be entitled, including veterans' compensation and pensions of any type, old-age survivors, and disability insurance benefits; railroad retirement benefits; and unemployment compensation.
5. "Institution" means a facility licensed under North Dakota Century Code chapter 23-09.3.
6. "Instrumental activities of daily living" means activities to support independent living, including housekeeping, shopping, laundry, transportation, and meal preparation.
7. "Necessary benefits" means those benefits:
a. Provided under this chapter;
b. Identified by the department, or a human service zone under the direction and supervision of the department, as appropriate to meet the needs of an applicant or recipient; and
c. Which, when provided in coordination and conjunction with benefits available from any other source, represent the means least costly to the department of meeting the needs of the applicant or recipient.

N.D. Admin Code 75-02-10-01

Effective May 1, 1995; amended effective January 1, 1997; June 1, 2002; April 1, 2012.
Amended by Administrative Rules Supplement 2020-378, October 2020, effective 5/19/2020.

General Authority: NDCC 50-06-16, 50-24.5-02(8)

Law Implemented: NDCC 50-24.5