Current through Register Vol. 46, No. 39, September 25, 2024
(a) This section
shall apply to programs with Medicaid reimbursement calculated pursuant to this
Part.
(b) No program or service
governed by this Part shall have its own facility specific or program specific
capital add-on. Instead, capital costs from submitted cost reports shall be
reviewed by the Office and a regional, and not separately identifiable, capital
component shall be built into the operating fees. Such fees shall constitute
payment in full for all costs of operating the program, including capital
costs, unless otherwise specified.
(c) Allowable Costs.
(1) Allowable capital costs means the costs
to a program operated by an applicant with respect to the acquisition of real
property estates, interests, and cooperative interests in realty, their design,
construction, reconstruction, rehabilitation and improvement, original
furnishings and equipment, site development, and appurtenances of a facility
and as otherwise identified in this Title.
(2) Unless otherwise specified in this Part,
costs of ownership of real property shall be allowable in the following
categories; depreciation, interest, and closing costs on the purchase and
financing of real property, including fees related to loans from the Dormitory
Authority of the State of New York (DASNY). Providers should not report costs
that were not actually incurred by the provider (e.g., debt service or fees on
DASNY loans that were paid by the State of New York or refunded to the provider
by the State of New York).
(3)
Costs related to Dormitory Authority loans shall be allowable, unless otherwise
paid by the State of New York, as follows:
(i)
Interest cost accruing from Dormitory Authority mortgage loans pursuant to
subdivision 13-d of section 5 of the Facilities Development Corporation Act,
net of the portion of such interest cost attributable to operating costs, is an
allowable cost. That portion of the interest cost attributable to allowable
start-up costs is also allowable. That portion of the loan principal that is
attributable to depreciable or amortizable costs, under the rules of HIM 15, is
an allowable cost and shall be reimbursed as depreciation or amortization in
accordance with any requirements and conditions. Any portion of the loan
principal that is attributable to costs that are not depreciable or amortizable
under the rules of HIM 15 is not allowable for reimbursement.
(ii) Fees imposed by the office and annual
administrative fees imposed by the Dormitory Authority in connection with
Dormitory Authority mortgage loans shall be allowable costs.
(iii) Interest payments on Dormitory
Authority loans pursuant to this subdivision for capital indebtedness and
start-up costs will be considered allowable where such interest expense results
from approved capital indebtedness and/or start-up costs in accordance with
this Title.
(iv) Interest payment
on Dormitory Authority loans pursuant to the provisions of this Part are
allowable in excess of the amount associated with the outstanding principal
balance prior to refinancing only if the purpose of the additional debt is to
acquire assets to be used for care of the persons served by the program and all
other applicable requirements of this Part are met.
(v) The Office may recoup, in full or in
part, the interest and fee reimbursement for DASNY loans attributable to a
particular service. The office may also recoup, in full or in part, the annual
depreciation or amortization reimbursement for costs financing through DASNY
mortgage loans. The amount of Dormitory Authority mortgage loan interest, fee,
depreciation, and amortization recoupments shall be equal to or less than the
provider's actual reimbursement for such costs. In no case shall these
recoupments exceed such reimbursement.
(d) Start-up costs. Upon the approval by the
office, the approved start-up costs of new programs shall be amortized and
reimbursed to the provider over a period not to exceed five years.