801—10.15 (35D) Per diems.
	 10.15(1) For members not participating in the Title XIX program, the per diem by which the billable days shall be multiplied shall be established as follows:
	  a.   	 Nursing and infirmary levels of care.
	 (1) 	 The charge for care is the per diem submitted by IVH to department of human services for the Title XIX certified units as calculated in January and July of each year for the preceding six months.
	 (2) 	 The charge for care shall be adjusted, if necessary, semiannually on March 1 and September 1 of each year.
	 (3) 	 Members or financial legal representatives shall be sent a notice one month in advance of the rate change.
	  b.   	 Domiciliary level of care.
	 (1) 	 The total cost of care per member shall be determined in January and July of each year for the preceding six months and calculated in a manner similar to the nursing level of care. This cost shall be the charge for care.
	 (2) 	 The charge for care shall be adjusted, if necessary, semiannually on March 1 and September 1 of each year.
	 (3) 	 Members or financial legal representatives shall be sent a notice one month in advance of the rate change.
	 10.15(2) Veteran members not living on Title XIX certified units and those living on Title XIX certified units but not eligible for Title XIX medical assistance for whom IVH receives a per diem from the U.S. DVA (under Title 38). IVH shall consider this per diem as a third-party reimbursement to the charge for care and shall be an offset to the member support bill. The offset of the per diem received (billed to DVA) shall be shown as an offset for the month billed.
	 10.15(3) For members not living on Title XIX certified units and those living on Title XIX certified units but not eligible for Title XIX medical assistance. The daily per diem charge shall be reduced by an amount equal to the “usual” Medicare premium calculated as a per diem. This offset shall be available only to members eligible for Medicare insurance.
	 10.15(4) For members not living on Title XIX certified units and those living on Title XIX certified units but not eligible for Title XIX medical assistance. The member support charge shall be reduced in accordance with subrules 10.15(2) and 10.15(3), if applicable. The member shall then contribute all remaining available resources up to the charge for care.
Members receiving DVA pension and aid and attendance shall be considered as having used the amount equal to aid and attendance first in payment for their care at IVH.
	 10.15(5) Payment of support is due on the tenth of the month in which the monthly support bill is received, or ten business days after the member’s last income deposit for that month.
	  a.   	 If payment is not received by IVH within 30 days following the due date, a notice of discharge may be issued.
	  b.   	 If there are extenuating circumstances, the member or legal representative should meet with the commandant or designee to work out a schedule of payments.