Compilation of Rules and Regulations of the State of Georgia
Rule 690-1-.02 - Definitions

Universal Citation: GA Rules and Regs r 690-1-.02

Current through Rules and Regulations filed through June 21, 2023

For purposes of this rule (Chapter 690-1-1) the following terms and words shall have the meanings provided in this chapter.

(1) VA's A&A Benefit: All veteran patients of SVHs are eligible to receive the VA's A&A benefit (690-1-1-.01(2)) because they are patients in skilled nursing homes/SVHs. The VA's A&A benefit is income based and is dependent upon the amount of income veteran patients have. This determines how much the value of the benefit is to be received by the veteran patients. In other words, veteran patients eligible to receive the benefit may not receive a cash payment of the benefit because they are "over income," up to the full amount of the benefit for which they qualify based on their income levels.

(2) Admission Eligibility for Georgia's SVHs: Admission to and residency in Georgia's SVHs is available for the use and care of disabled war veterans discharged under other than dishonorable conditions. The term "war veterans" means any veterans who were discharged under other than dishonorable conditions and who served on active duty in the armed forces of the United States, or on active duty in a reserve component of the armed forces of the United States, including the National Guard, during wartime or during the period beginning January 31, 1955, and ending on May 7, 1975 (O.C.G.A § 38-4-50). However, a war veteran shall not be eligible for admission to Georgia's SVHs unless such war veteran has been a resident of this state for a period of at least five years immediately prior to application for admission (O.C.G.A. § 38-4-55). While payment of approved fees by veteran patients is a requirement to be and to remain residents of SVHs, O.C.G.A § 38-4-56 does not create a new criterion for admission to SVHs.

(3) Daily Fee: The Daily Fee is based on the value of the VA's A&A benefit for a single veteran with no income, as determined by the annual VA schedule. For purposes of this rule the daily value of the VA's Pension with A&A benefit provided to a single veteran with no income, minus the daily value of the pension for a single veteran with no income, times 12 months, divided by 365 days will equal the Daily Fee. Example: X = ((Y - Z) x 12) / 365), where X is the Daily Fee, Y is the value of the VA's pension with A&A monthly benefit for a single veteran with no (zero) income, and Z is the value of the VA's monthly pension for a single veteran with no (zero) income.

(4) Federal Poverty Guidelines: The U.S. Department of Health and Human Services Poverty Guidelines for the 48 Contiguous States and the District of Columbia is published periodically for use for various purposes. In this Chapter these guidelines will serve as a basis for determining eligibility to request a waiver from payment of the Daily Fee provided for in this Chapter. As used in this Chapter, these guidelines reflect gross income before deductions, taxes and other adjustments.

(5) Residency: Veterans who reside at or live in SVHs as patients and receive medical care and services provided by the SVHs are considered residents of the SVHs and are subject to the payment of the Daily Fee, as provided for in this chapter. Residency begins on the days of admission of veterans to veteran patient status at the SVHs and ends when the veteran patients are permanently discharged from the SVHs or their death at the SVHs. Temporary discharges from the SVHs for medical or non-medical (leave) reasons will not terminate the residency of the veteran patients.

(6) 70% Service Connected Disabled Veteran Patients: Under current federal law, these are veterans who have been rated by the VA as 70% Service Connected Disabled, or higher, who are admitted as veteran patients of SVHs. Under current federal law, the VA per-diem payments to SVHs for the residency and care of these veteran patients in SVHs is payment in full; thus, based on this status Daily Fees cannot be charged to these veteran patients.

(7) State Veterans' Home (SVH): This encompassing term is used in this Chapter and includes other similar terms, such as, State War Veterans Home, a facility of the State War Veterans Home, Georgia State War Veterans Home, etc.

(8) Substantial Hardship: For purposes of this rule substantial hardship means a significant, unique, considerable in degree and large demonstrable economic suffering, adversity or misfortune to the veteran patients requesting waivers and/or their families, which impair the ability of the veteran patients and/or their families to provide for their economic viability.

(9) U.S. Department of Veterans Affairs (VA): As used in this Chapter, the VA is the agency of the federal government that administers federal benefits for veterans, as provided for in federal law and rules and regulations. The federal benefits include, but are not limited to, the Aid and Attendance (A&A) benefit, compensation for service connected veterans, pensions for certain other veterans and per diem payments for a portion of the operating costs of SVHs.

(10) Veteran Patient: As used in this Chapter, a veteran patient is a veteran who is a patient residing in and receiving medical services from a SVH.

(11) Veterans Field Service Offices and Veterans Field Service Officers (VFSO): The Department of Veterans Service operates field service offices located at each of the SVHs, as well as other locations throughout the State of Georgia. Each of the field service offices is staffed with one or more field service officers. As used in this Chapter, the abbreviation "VFSO" may indicate either the field service offices or field service officers and the context of the sentence or paragraph will determine which usage of the abbreviation is being observed.

(12) Waiver: Waiver means a decision by an the SVHs, or the Department of Veterans Service, based on substantial hardship, not to charge all or part of the Daily Fee to a veteran patient who is subject to this rule.

O.C.G.A. §§ 38-4-50; 38-4-51; 38-4-55; 38-4-56.

New Rule entitled, "Definitions" adopted. F. Nov. 1, 2012; eff. Nov. 21, 2012.

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