Long-term services and supports (LTSS) manual

Treatment of entrance fees in Continuing Care Communities, clients living in fraternal/religious/benevolent nursing facility

Revised Date: 
January 14, 2014

Purpose: Treatment of entrance fees in a continuing care retirement community or life care community is considered a resource available to the client in certain conditions. How to treat life care contracts signed by the client and the facility and/or organization.

WAC 182-513-1396 People living in a fraternal, religious, or benevolent nursing facility.

Effective February 20, 2017

  1. The agency or its designee determines apple health coverage under noninstitutional rules for a person who meets all other eligibility requirements and lives in a licensed, but nonmedicaid-contracted facility operated by a fraternal, religious, or benevolent organization.
  2. Nothing in subsection (1) of this section prevents the agency or its designee from evaluating contracts with facilities not described in subsection (1) of this section.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

WAC 182-513-1397 Treatment of entrance fees of individuals residing in continuing care retirement communities

Effective January 1, 2013

The following rule applies to long-term care medicaid applicants who reside in a continuing care retirement communities or life care communities that collect an entrance fee on admission from residents:

  1. Treatment of Entrance Fee. An individual's entrance fee in a continuing care retirement community or life care community is considered a resource available to the individual to the extent that:
    1. The individual has the ability to use the entrance fee, or the contract provides that the entrance fee may be used to pay for care should other resources or income of the individual be insufficient to pay for care.
    2. the individual is eligible for a refund of any remaining entrance fee when the individual dies or terminates the continuing care retirement community or life care community contract and leaves the community; and
    3. The entrance fee does not confer an ownership interest in the continuing care retirement community or life care community.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Clarifying Information

Residents of continuing care retirement, life care communities, fraternal, religious or benevolent nursing facilities often sign life care contracts with the facility. These contracts offer institutional and/or medical care in exchange for the surrender of the client's income and resources. See WAC 182-513-1397 regarding the treatment of the entrance fee for individuals that reside in a continuing care retirement or life care community. An entrance fee is considered an available resource based on the criteria in this WAC.

Worker Responsibilities

  1. If the client signed a contract for life care, consider the following to determine if adequate consideration was received when assets were transferred to the facility:
    1. The amount of the client's assets surrendered under the contract
    2. The client's cost of care up to the date of application for LTC services
  2. Follow necessary supplemental accommodation (NSA) procedures described in WAC 182-503-0120 when appropriate.