B. Final Capital Cost.
(1) The determination of a provider's
allowable final Capital per diem rate for the cost items under §A of this
regulation is calculated as follows:
(a)
Appraise each facility at least every 4 years;
(b) 2 months before the period for which
final Capital rates are being calculated, determine the most recent appraisal
for each facility;
(c) Determine
the cost report for each facility that covers the date of valuation of the
appraisal identified in §B(1)(b) of this regulation, or, if a cost report
covering the date of valuation has not been filed by the facility, determine
the closest match to the date of valuation available 2 months before the period
for which final Capital rates are being calculated,
(d) Multiply the ending licensed nursing
facility beds from the cost report in §B(1)(c) of this regulation,
adjusted for accuracy using information available 2 months before setting the
rate in this regulation, by the land per bed amount from the appraisal to
calculate a total land amount;
(e)
Sum the total land amount, building, and equipment;
(f) Divide the total appraisal amount by the
number of ending licensed nursing facility beds, under §B(1)(d) of this
regulation, to determine an appraised value per bed;
(g) Apply a maximum appraised value per bed
of $120,000;
(h) Multiply the final
appraised value per bed times the number of ending licensed nursing facility
beds, under §B(1)(d) of this regulation, to determine the facility's gross
value;
(i) For facilities in
Baltimore City, multiply the facility's gross value by 10 percent to determine
the facility's annual fair rental value;
(j) For facilities in all jurisdictions
except Baltimore City, multiply the facility's gross value by 8 percent to
determine the facility's annual fair rental value;
(k) Divide the facility's annual fair rental
value by the greater of actual resident days, or days at full occupancy times
an occupancy standard calculated under Regulation .09B(4) of this chapter, to
establish a fair rental value per diem rate;
(l) Divide real estate taxes obtained from
the most recent desk reviewed cost report available 2 months before the start
of the rate year by the greater of actual resident days, or days at full
occupancy times an occupancy standard calculated under Regulation .09B(4) of
this chapter, to establish a real estate tax per diem rate; and
(m) Sum the fair rental value and the real
estate tax per diem rates.
(2) The appraisal may not include any value
associated with a Certificate of Need for nursing home beds.
