Current through Register Vol. 35, No. 18, September 24, 2024
A. Direct patient care: No
ceiling will be imposed on this cost center.
B. A&G and R&B: The per diem costs
for administration and general and for room and board will be grouped together
for the establishment of a ceiling. This ceiling will be calculated at one
hundred ten percent of the median of allowable costs for the base year, indexed
to 12/31 of the base year. The ceiling will then be indexed to the mid-point of
year one and set. For years two and three, the ceiling will not be
recalculated, but rather will be indexed forward using the appropriate
inflation factor described earlier in these regulations.
C. Facility cost:
(1) No ceiling will be imposed on this cost
center, except in relation to leases.
(2) Effective for leases executed and binding
on both parties on or after September 1, 1990, total allowable lease costs for
the entire term of the lease for each facility will be limited to an amount
determined by a discounted cash flow technique which will provide the lessor
and annual rate of return on the fair market value of the facility equal to one
times the average of the rates of interest on special issues of public debt
obligations issued to the federal hospital insurance trust fund for the twelve
months prior to the date the facility became a provider in the New Mexico
medicaid program. The rates of interest for this fund are published in both the
federal register and the commerce clearing house (CCH).
(3) The rate of return described above will
be exclusive of any escalator clauses contained in the lease. The effect of
escalator clauses will be considered at the time they become effective, and the
reasonableness of such clauses will be determined by the inflation factor
described in Subsection B of
8.313.3.12 NMAC of these
regulations.
(4) Any appraisal
necessary to determine the fair market value of the facility will be the sole
responsibility of the provider and is not an allowable cost for reimbursement
under the program. The appraisals must be conducted by an appraiser certified
by a nationally recognized entity, and such appraiser must be familiar with the
health care industry, specifically long term care, and must be familiar with
geographic area in which the facility is located. Prior to the appraisal taking
place, the provider must submit to the HCA the name of the appraiser, a copy of
their certification, and a brief description of the appraiser's relevant
experience. The use of a particular appraiser is subject to the approval of the
HCA.
