Investigation of ability to pay

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53-1-406. Investigation of ability to pay. (1) Before determining an ability to pay under 53-1-405, the department shall investigate each resident's and each financially responsible person's ability to pay. For purposes of the investigation, the determination of ability to pay, or any later review or redetermination, the department may require the resident or financially responsible person to complete, sign, and submit financial information and documentation, including financial statements on a form supplied by the department.

(2) Each agency of the state shall provide to the department all reasonable assistance and all requested information and documents necessary for the financial investigation of residents or financially responsible persons. The department of revenue may not provide confidential tax return information to the department without the consent of the taxpayer.

(3) Upon request of the department, the resident or financially responsible person shall make available to the department and shall cooperate with the department in obtaining any financial information and documentation that the department considers essential for the purpose of determining ability to pay and that, under federal law, the department is not prohibited from seeking or obtaining from the resident or financially responsible person. The information and documentation that the department is entitled to receive include but are not limited to:

(a) income statements and verification;

(b) liability statements and verification;

(c) tax returns and related forms, documents, and records, but the department of revenue may not provide confidential tax return information to the department without the consent of the taxpayer;

(d) asset statements and descriptions, including valuation appraisals;

(e) records of a bank or other financial institution, including account balances, loan statements, account ownership information, and transaction records;

(f) expense statements and verification;

(g) financial statements, including existing financial statements and financial statements on forms provided by the department;

(h) releases authorizing the department to obtain information or documents directly from an employer, creditor, federal agency, financial institution, or other person or entity; and

(i) any other information or documentation necessary to the determination.

(4) If a resident or financially responsible person fails to provide or cooperate in obtaining the financial information or documentation requested by the department, the department may make a determination of ability to pay based upon any information or documentation available to the department, including a determination of ability to pay up to the full cost of care. The determination is effective until the requested information and documentation are provided and the department makes a new determination of ability to pay, taking into consideration the additional information and documentation.

(5) In a hearing under 53-1-407, if a hearings examiner determines that information or documentation is relevant and admissible and orders the resident or financially responsible person to produce it and if the resident or financially responsible person fails or refuses to produce that information or documentation, a determination of ability to pay the full cost of care may be affirmed or payment of the full cost of care ordered, regardless of other information presented.

History: En. Sec. 15, Ch. 199, L. 1965; amd. Sec. 1, Ch. 240, L. 1969; amd. Sec. 53, Ch. 120, L. 1974; amd. Sec. 2, Ch. 336, L. 1974; amd. Sec. 46, Ch. 37, L. 1977; amd. Sec. 3, Ch. 450, L. 1977; R.C.M. 1947, 80-1603(3); amd. Sec. 6, Ch. 190, L. 1997.


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