{
 "name": "US Medicaid transfer-penalty divisors by state",
 "url": "https://thecareledger.org/data",
 "identifier": "https://doi.org/10.5281/zenodo.22281243",
 "doi": "10.5281/zenodo.22281243",
 "same_as": [
  "https://www.wikidata.org/entity/Q141266096"
 ],
 "publisher": "The Care Ledger",
 "contact": "contact@thecareledger.org",
 "update_cadence": "Sources are rechecked on their documented cadence; changes require review.",
 "citation": "The Care Ledger. US Medicaid transfer-penalty divisors by state. https://doi.org/10.5281/zenodo.22281243",
 "license": "https://creativecommons.org/licenses/by/4.0/",
 "license_name": "CC BY 4.0",
 "attribution": "The Care Ledger, thecareledger.org",
 "version": "2026-09-02",
 "generated_from": "divisors_master.csv",
 "row_count": 531,
 "jurisdictions_with_a_figure": 42,
 "jurisdictions_total": 51,
 "evidence_grades": {
  "corroborated": "Read from a handbook, chart or dated release rather than transcribed from the state's own primary rule document. Corroborated, not primary.",
  "primary": "Transcribed from the state's own primary source document.",
  "unverified": "NOT verified against a primary state document. The only source located is secondary or paywalled. Treat this figure as unverified."
 },
 "columns": [
  "state",
  "region",
  "divisor_type",
  "authority_level",
  "program",
  "effective_date",
  "date_precision",
  "asserted_through",
  "rounding_rule",
  "rounding_quote",
  "governing_date",
  "governing_quote",
  "rule_source_url",
  "value",
  "unit",
  "source_url",
  "retrieved",
  "method",
  "evidence_grade"
 ],
 "column_definitions": {
  "state": {
   "description": "Two-letter postal code; DC is included."
  },
  "region": {
   "description": "Sub-state region, or statewide."
  },
  "divisor_type": {
   "description": "Geographic form of the published divisor.",
   "enum": [
    "statewide",
    "regional"
   ]
  },
  "authority_level": {
   "description": "Whether the figure is set at state or region level."
  },
  "program": {
   "description": "Program governed by the figure."
  },
  "effective_date": {
   "description": "ISO date on which the figure took effect."
  },
  "date_precision": {
   "description": "Precision stated by the source; no precision is invented.",
   "enum": [
    "exact",
    "month",
    "year_only"
   ]
  },
  "asserted_through": {
   "description": "Last date the source expressly says the figure applied, when published."
  },
  "rounding_rule": {
   "description": "Project vocabulary; the source quote remains authoritative. Blank means unreviewed; unstated means reviewed but silent.",
   "enum": [
    "up",
    "down",
    "none",
    "partial_days",
    "unstated"
   ]
  },
  "rounding_quote": {
   "description": "Verbatim support for rounding_rule."
  },
  "governing_date": {
   "description": "Date the reviewed rule says selects the divisor. Blank means unreviewed; unstated means reviewed but silent.",
   "enum": [
    "application",
    "transfer",
    "later_of_both",
    "current",
    "fiscal_year",
    "unstated"
   ]
  },
  "governing_quote": {
   "description": "Verbatim support for governing_date."
  },
  "rule_source_url": {
   "description": "Policy source for the rule fields when different from source_url."
  },
  "value": {
   "description": "Published divisor value in its native unit."
  },
  "unit": {
   "description": "Native unit published by the state.",
   "enum": [
    "day",
    "month"
   ]
  },
  "source_url": {
   "description": "Document from which the figure was read."
  },
  "retrieved": {
   "description": "Date the source document was last opened."
  },
  "method": {
   "description": "Collection provenance used to derive evidence_grade."
  },
  "evidence_grade": {
   "description": "Trust grade derived from method.",
   "enum": [
    "corroborated",
    "primary",
    "unverified"
   ]
  }
 },
 "rows": [
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2017-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "5383.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2018-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "5493.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2019-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "5749.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2020-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "5871.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2021-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "6023.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2022-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "7151.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2023-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "8334.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2024-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "8502.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2025-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "8834.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AR",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2026-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "9110.0",
   "unit": "month",
   "source_url": "https://humanservices.arkansas.gov/wp-content/uploads/Medical-Services-Appendices-8-26.pdf",
   "retrieved": "2026-08-27",
   "method": "appendix_r_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1988-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "1627.2",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1989-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "1885.8",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1990-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "1926.0",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1991-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2083.5",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1992-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2181.0",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1993-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2321.1",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1994-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2426.4",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1995-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2530.67",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1996-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2642.6",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1997-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2688.6",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1998-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2802.28",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2000-04-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2914.37",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
   "retrieved": "2026-08-27",
   "method": "epm_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "AZ",
   "region": "All other counties",
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   "governing_quote": "",
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   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
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   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
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   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "8132.22",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "1785.9",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "1972.8",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "1987.2",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2178.0",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2283.0",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2406.3",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2509.5",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2651.42",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rounding_rule": "partial_days",
   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2767.92",
   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rounding_quote": "the fraction of a month is not dropped. The fraction results in a partial penalty month. However, when calculating the partial penalty month, any fraction of a day is dropped.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "2823.9",
   "unit": "month",
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   "governing_date": "",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "governing_date": "",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "governing_date": "",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "governing_date": "",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
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   "governing_date": "",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
   "value": "3898.95",
   "unit": "month",
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   "governing_date": "",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "unit": "month",
   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "source_url": "https://epm.azahcccs.gov/epmplus/Examples/E905_Transfer_Penalty_Period_Examples/I_Prior_Private_Pay_Rates.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "rule_source_url": "https://epm.azahcccs.gov/epmplus/Policy/Chapter_900_Transfers/905_Transfer_Penalty_Period.htm",
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   "divisor_type": "statewide",
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   "rule_source_url": "",
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   "source_url": "https://mdhhs-pres-prod.michigan.gov/olmweb/EX/BP/Public/BEM/405.pdf",
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   "source_url": "https://mdhhs-pres-prod.michigan.gov/olmweb/EX/BP/Public/BEM/405.pdf",
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   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "364.9",
   "unit": "day",
   "source_url": "http://services.dpw.state.pa.us/oimpolicymanuals/ltc/440_Resources/440_Appendix_A.htm",
   "retrieved": "2026-08-27",
   "method": "handbook_appendix_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "PA",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2022-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "482.5",
   "unit": "day",
   "source_url": "http://services.dpw.state.pa.us/oimpolicymanuals/ltc/440_Resources/440_Appendix_A.htm",
   "retrieved": "2026-08-27",
   "method": "handbook_appendix_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "PA",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2023-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "423.11",
   "unit": "day",
   "source_url": "http://services.dpw.state.pa.us/oimpolicymanuals/ltc/440_Resources/440_Appendix_A.htm",
   "retrieved": "2026-08-27",
   "method": "handbook_appendix_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "PA",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2024-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "379.65",
   "unit": "day",
   "source_url": "http://services.dpw.state.pa.us/oimpolicymanuals/ltc/440_Resources/440_Appendix_A.htm",
   "retrieved": "2026-08-27",
   "method": "handbook_appendix_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "PA",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2025-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "399.8",
   "unit": "day",
   "source_url": "http://services.dpw.state.pa.us/oimpolicymanuals/ltc/440_Resources/440_Appendix_A.htm",
   "retrieved": "2026-08-27",
   "method": "handbook_appendix_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "PA",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2026-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "421.2",
   "unit": "day",
   "source_url": "http://services.dpw.state.pa.us/oimpolicymanuals/ltc/440_Resources/440_Appendix_A.htm",
   "retrieved": "2026-08-27",
   "method": "handbook_appendix_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "RI",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2026-07-27",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "partial_days",
   "rounding_quote": "the State imposes a partial-month penalty and does not round down or disregard any fractional period of ineligibility",
   "governing_date": "current",
   "governing_quote": "at the current statewide average private pay rate",
   "rule_source_url": "",
   "value": "12106.0",
   "unit": "month",
   "source_url": "https://rules.sos.ri.gov/regulations/part/210-50-00-6",
   "retrieved": "2026-08-27",
   "method": "rule_filing_header_effective_date",
   "evidence_grade": "primary"
  },
  {
   "state": "SC",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2026-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "9758.58",
   "unit": "month",
   "source_url": "https://img1.scdhhs.gov/mppm/SCMPPM/Section_300.docx",
   "retrieved": "2026-08-27",
   "method": "mppm_appendix_d",
   "evidence_grade": "primary"
  },
  {
   "state": "TN",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2011-06-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down to the nearest whole number to determine the penalty period of 65 days.",
   "governing_date": "later_of_both",
   "governing_quote": "at the time of application for TennCare Medicaid or the date of transfer, whichever is later",
   "rule_source_url": "",
   "value": "152.23",
   "unit": "day",
   "source_url": "https://www.tn.gov/content/dam/tn/tenncare/documents/TransferOfAssetsAndPenaltyPeriods.pdf",
   "retrieved": "2026-08-27",
   "method": "policy_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TN",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2012-12-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down to the nearest whole number to determine the penalty period of 65 days.",
   "governing_date": "later_of_both",
   "governing_quote": "at the time of application for TennCare Medicaid or the date of transfer, whichever is later",
   "rule_source_url": "",
   "value": "153.02",
   "unit": "day",
   "source_url": "https://www.tn.gov/content/dam/tn/tenncare/documents/TransferOfAssetsAndPenaltyPeriods.pdf",
   "retrieved": "2026-08-27",
   "method": "policy_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TN",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2015-03-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down to the nearest whole number to determine the penalty period of 65 days.",
   "governing_date": "later_of_both",
   "governing_quote": "at the time of application for TennCare Medicaid or the date of transfer, whichever is later",
   "rule_source_url": "",
   "value": "182.42",
   "unit": "day",
   "source_url": "https://www.tn.gov/content/dam/tn/tenncare/documents/TransferOfAssetsAndPenaltyPeriods.pdf",
   "retrieved": "2026-08-27",
   "method": "policy_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TN",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2021-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down to the nearest whole number to determine the penalty period of 65 days.",
   "governing_date": "later_of_both",
   "governing_quote": "at the time of application for TennCare Medicaid or the date of transfer, whichever is later",
   "rule_source_url": "",
   "value": "219.36",
   "unit": "day",
   "source_url": "https://www.tn.gov/content/dam/tn/tenncare/documents/TransferOfAssetsAndPenaltyPeriods.pdf",
   "retrieved": "2026-08-27",
   "method": "policy_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TN",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2022-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down to the nearest whole number to determine the penalty period of 65 days.",
   "governing_date": "later_of_both",
   "governing_quote": "at the time of application for TennCare Medicaid or the date of transfer, whichever is later",
   "rule_source_url": "",
   "value": "228.41",
   "unit": "day",
   "source_url": "https://www.tn.gov/content/dam/tn/tenncare/documents/TransferOfAssetsAndPenaltyPeriods.pdf",
   "retrieved": "2026-08-27",
   "method": "policy_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TN",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2023-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down to the nearest whole number to determine the penalty period of 65 days.",
   "governing_date": "later_of_both",
   "governing_quote": "at the time of application for TennCare Medicaid or the date of transfer, whichever is later",
   "rule_source_url": "",
   "value": "236.34",
   "unit": "day",
   "source_url": "https://www.tn.gov/content/dam/tn/tenncare/documents/TransferOfAssetsAndPenaltyPeriods.pdf",
   "retrieved": "2026-08-27",
   "method": "policy_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TN",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2024-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down to the nearest whole number to determine the penalty period of 65 days.",
   "governing_date": "later_of_both",
   "governing_quote": "at the time of application for TennCare Medicaid or the date of transfer, whichever is later",
   "rule_source_url": "",
   "value": "274.0",
   "unit": "day",
   "source_url": "https://www.tn.gov/content/dam/tn/tenncare/documents/TransferOfAssetsAndPenaltyPeriods.pdf",
   "retrieved": "2026-08-27",
   "method": "policy_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TN",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2025-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down to the nearest whole number to determine the penalty period of 65 days.",
   "governing_date": "later_of_both",
   "governing_quote": "at the time of application for TennCare Medicaid or the date of transfer, whichever is later",
   "rule_source_url": "",
   "value": "286.0",
   "unit": "day",
   "source_url": "https://www.tn.gov/content/dam/tn/tenncare/documents/TransferOfAssetsAndPenaltyPeriods.pdf",
   "retrieved": "2026-08-27",
   "method": "policy_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TN",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2026-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down to the nearest whole number to determine the penalty period of 65 days.",
   "governing_date": "later_of_both",
   "governing_quote": "at the time of application for TennCare Medicaid or the date of transfer, whichever is later",
   "rule_source_url": "",
   "value": "295.87",
   "unit": "day",
   "source_url": "https://www.tn.gov/content/dam/tn/tenncare/documents/TransferOfAssetsAndPenaltyPeriods.pdf",
   "retrieved": "2026-08-27",
   "method": "policy_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2005-11-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "117.08",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2007-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "122.5",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2009-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "130.88",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2011-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "142.92",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2013-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "156.34",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2015-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "162.41",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2017-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "172.65",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2019-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "213.71",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2021-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "237.93",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2023-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "242.13",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "TX",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2025-09-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "Round down partial amounts to the whole number of days.",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "262.37",
   "unit": "day",
   "source_url": "https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/i-5100-transfer-assets-divisor",
   "retrieved": "2026-08-27",
   "method": "handbook_inline_history",
   "evidence_grade": "primary"
  },
  {
   "state": "UT",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2026-07-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "7344.0",
   "unit": "month",
   "source_url": "https://oepmanuals.dhhs.utah.gov/Tables/TABLE_II-A_-_Long_Term_Care_figures.htm",
   "retrieved": "2026-09-02",
   "method": "eligibility_manual_table_current",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1996-10-01",
   "date_precision": "exact",
   "asserted_through": "1997-09-30",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "2564.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1997-10-01",
   "date_precision": "exact",
   "asserted_through": "1999-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "2585.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2000-01-01",
   "date_precision": "exact",
   "asserted_through": "2000-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "2596.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2001-01-01",
   "date_precision": "exact",
   "asserted_through": "2001-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "3376.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2002-01-01",
   "date_precision": "exact",
   "asserted_through": "2003-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "3517.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2004-01-01",
   "date_precision": "exact",
   "asserted_through": "2007-09-30",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "4060.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2007-10-01",
   "date_precision": "exact",
   "asserted_through": "2010-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "4954.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2011-01-01",
   "date_precision": "exact",
   "asserted_through": "2014-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "5933.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2015-01-01",
   "date_precision": "exact",
   "asserted_through": "2018-06-30",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "5933.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2018-07-01",
   "date_precision": "exact",
   "asserted_through": "2020-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "6422.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2021-01-01",
   "date_precision": "exact",
   "asserted_through": "2024-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "7023.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "All other localities",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2025-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "7324.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1996-10-01",
   "date_precision": "exact",
   "asserted_through": "1997-09-30",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "2564.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "1997-10-01",
   "date_precision": "exact",
   "asserted_through": "1999-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "3315.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2000-01-01",
   "date_precision": "exact",
   "asserted_through": "2000-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "3275.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2001-01-01",
   "date_precision": "exact",
   "asserted_through": "2001-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "4502.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2002-01-01",
   "date_precision": "exact",
   "asserted_through": "2003-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "4684.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2004-01-01",
   "date_precision": "exact",
   "asserted_through": "2007-09-30",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "5403.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2007-10-01",
   "date_precision": "exact",
   "asserted_through": "2010-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "6654.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2011-01-01",
   "date_precision": "exact",
   "asserted_through": "2014-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "7734.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2015-01-01",
   "date_precision": "exact",
   "asserted_through": "2018-06-30",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "8367.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2018-07-01",
   "date_precision": "exact",
   "asserted_through": "2020-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "9032.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2021-01-01",
   "date_precision": "exact",
   "asserted_through": "2024-12-31",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "9268.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "VA",
   "region": "Northern Virginia",
   "divisor_type": "regional",
   "authority_level": "region",
   "program": "nursing_facility",
   "effective_date": "2025-01-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "down",
   "rounding_quote": "The penalty period includes the fractional portion of the month, rounded down to a day.",
   "governing_date": "application",
   "governing_quote": "the average monthly cost of nursing facility services to a private-pay patient in his locality at the time of the application for Medicaid",
   "rule_source_url": "",
   "value": "9703.0",
   "unit": "month",
   "source_url": "https://www.dmas.virginia.gov/media/hksogjdf/chapter-m14-long-term-care.pdf",
   "retrieved": "2026-09-02",
   "method": "manual_inline_regional_history",
   "evidence_grade": "primary"
  },
  {
   "state": "WA",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2025-10-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "462.0",
   "unit": "day",
   "source_url": "https://www.hca.wa.gov/assets/free-or-low-cost/income-standards.pdf",
   "retrieved": "2026-08-27",
   "method": "income_standards_chart",
   "evidence_grade": "primary"
  },
  {
   "state": "WI",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2016-07-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "259.08",
   "unit": "day",
   "source_url": "https://www.emhandbooks.wisconsin.gov/meh-ebd/history/",
   "retrieved": "2026-08-27",
   "method": "handbook_archived_release_prose_date",
   "evidence_grade": "corroborated"
  },
  {
   "state": "WI",
   "region": "statewide",
   "divisor_type": "statewide",
   "authority_level": "state",
   "program": "nursing_facility",
   "effective_date": "2017-07-01",
   "date_precision": "exact",
   "asserted_through": "",
   "rounding_rule": "",
   "rounding_quote": "",
   "governing_date": "",
   "governing_quote": "",
   "rule_source_url": "",
   "value": "278.05",
   "unit": "day",
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 ]
}