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-67-30 - DECERTIFICATION/DELICENSING OF NURSING FACILITY BEDS
Current through 2024-38, September 18, 2024
30.1 Any request for delicensing/decertification of nursing facility beds must be submitted to the Department for review by Office of MaineCare Services. In addition to those guidelines, a floor plan must be submitted to the Office of MaineCare Services that describes the intended use, if any, of the space that the beds previously occupied. This floor plan will be reviewed by the Department. Reasons that the Department may deny the space as reimbursable under these Principles includes, but is not limited to, the following:
30.2 The following cost components shall be decreased by a percentage equal to the percentage of bed days decreased by the delicensing/decertification 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. The example used in Principle 29.2 to also applicable to this Principle. 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:
30.3 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 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.)
30.4 MaineCare savings derived from the delicensing of nursing facility beds must be credited to the MaineCare funding pool, in accordance with 22 MRSA §333-A. Pursuant to 22 MRSA §329(6), the nursing facility savings are not available to fund new MaineCare residential care beds.
