Current through Register Vol. 51, No. 19, September 20, 2024
A. The Other Patient Care cost center
includes:
(1) Medical director administrative
expenses;
(2) Pharmacy;
(3) Recreational activities;
(4) Patient care consultant
services;
(5) Food cost
(unprepared);
(6) Social services;
and
(7) Religious
services.
B. The
Department shall initially establish Other Patient Care prices for the rate
period January 1, 2015, through June 30, 2015, and thereafter rebase the Other
Patient Care prices between every 2 and 4 rate years. Prices may be rebased
more frequently if the Department determines that there is an error in the data
or in the calculation that results in a substantial difference in payment, or
if a significant change in provider behavior or costs has resulted in payment
that is inequitable across providers. The Department shall rebase based on the
following steps:
(1) The indexed costs shall
be calculated as set forth in Regulation .09B(1)-(3) of this chapter;
(2) Each cost report's indexed Other Patient
Care costs shall be divided by the actual days of nursing facility services to
arrive at the Other Patient Care cost per diem;
(3) For each reimbursement class, each cost
report's Medicaid resident days shall be used in the array of Other Patient
Care cost per diems identified in §B(2) of this regulation to calculate
the Other Patient Care Medicaid day weighted median using the method
established in Regulation .09B(5) of this chapter;
(4) The final price for Other Patient Care
costs for each reimbursement class is calculated as the geographic regional
Medicaid day weighted median multiplied by 1.07; and
(5) For years between periods when the prices
are rebased, the final price for Other Patient Care costs shall be calculated
as set forth in Regulation .09D of this chapter.
C. The final Other Patient Care rate for each
nursing facility is the Other Patient Care price for its reimbursement
class.
D. The reimbursement classes
for the Other Patient Care cost center are specified under Regulation .30B of
this chapter.
E. Kosher Kitchen
Add-on.
(1) Nursing facilities that maintain
kosher kitchens and have Other Patient Care costs in excess of the Other
Patient Care price in its reimbursement class that are attributable to food
costs shall receive an add-on to its final price an amount up to 15 percent of
the median per diem cost for food costs in its reimbursement class.
(2) For years between periods when the kosher
kitchen add-ons are rebased, the kosher kitchen add-on shall be calculated as
the prior year kosher kitchen add-on multiplied by the rate year monthly index
divided by the prior year monthly index as identified in Regulation .09B(3)(a)
of this chapter.
