How is Patient Pay amount calculated?

The Patient Pay amount is determined by taking the total income of the patient and subtracting any allowable expenses. This calculation is essential because it helps establish the amount that a patient can reasonably contribute towards their care costs in a nursing home setting. Allowable expenses may include medical bills, certain living expenses, and other costs defined by Medicaid or facility policies that are necessary for the patient's well-being.

When the income is reduced by these allowable expenses, the resulting figure reflects the financial capacity of the patient to pay for their care, ensuring that they are only contributing an amount they can afford while still meeting their essential needs.

Using the other formulas, such as adding allowable expenses or multiplying income by them, would not yield a result that accurately reflects the patient's disposable income for care. Therefore, considering income minus allowable expenses provides a clear and fair calculation for determining the Patient Pay amount.