Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter III - Allowances for Services
Section 144-101-III-67 - Principles of Reimbursement for Nursing Facilities
Subsection 144-101-III-67-29 - BEDBANKING OF NURSING FACILITY BEDS
Current through 2024-38, September 18, 2024
29.1 Any bed-banking request must be submitted to the Department for review by the Office of Elder Services and the Office of MaineCare Services. Nursing facilities are permitted to bank nursing facility beds, according to the guidelines contained in Title 22, Chapter 103A, Section 333, providing the space left vacant in the facility is not used for the creation of private rooms. In addition to those guidelines, a floor plan must be submitted to the Office of Aging and Disability Services that describes the intended use of the banked bed spaces. This floor plan will be reviewed by the Department. Reimbursement of costs associated with the banked beds will be allowed to the extent that such costs have been approved by the Department. Reasons that the Department may deny the space as reimbursable under these Principles includes, but is not limited to, the following:
29.2 Pursuant to Title 22, Chapter 103A, Section 333, the following cost components shall be decreased by a percentage equal to the percentage of bed days decreased by the banking of the beds. Total bed days used to calculate this percentage will be the audited days (as filed if audited days are not available) from the base year cost report. (e.g. If a facility decreased the number of beds by twenty-five percent (25%), and the total bed days in the base year equals 40,000 and the facility was at ninety percent (90%) occupancy = 36,000 days, then the bed days used in the calculation of the rate after the bed banking would equal ninety percent (90%) of 30,000 days or 27,000 days.) This percentage decrease would be used in the calculation of the new rate for the following cost components based on what the total audited costs (as filed, if audited costs are not available) in the base year:
29.3 Direct Care Cost Component - The Direct Care Cost Component will be decreased, subject to Licensing and Certification Regulations, by a percentage equal to fifty percent (50%) of the total percentage decrease based on the audited costs (as filed, if audited costs are not available) in the base year for the following areas:
(e.g. Using the example in Principle 29.2 of a twenty-five percent (25%) decrease, if the total audited costs (as filed, if audited costs are not available) of the RNs, LPNs, CNAs, CNAs-M, Contract Nursing, and benefits and taxes and medical supplies/medicine and drugs were $400,000 in the base year, the allowable costs for this component would be reduced by $50,000 or twelve and one half percent (12.5%). The ratio of labor costs to benefits and taxes as contained in the base year cost report would be used in the determination of the amounts decreased in each of those areas.) Reimbursement rates and all rate letters will have an effective date of the first day of the subsequent month after the date of the licensure change.)
