Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1130 - HOSPICE SERVICES
PAYMENT FOR HOSPICE CARE
Section 1130.73 - Additional payment for nursing facility residents
Universal Citation: 55 PA Code ยง 1130.73
Current through Register Vol. 54, No. 12, March 23, 2024
(a) An additional payment is made to a hospice for hospice care furnished to a MA recipient who is a resident of a skilled or intermediate care facility participating in the MA Program. The additional payment will take into account the cost of room and board. Room and board rates will be calculated as follows:
(1) Room and board cost data will be
retrieved from the most recently audited cost reports of participating skilled
nursing facilities.
(2) Appropriate
inflation factors will be applied to each facility's room and board cost as
needed to bring it forward to Fiscal Year 1989-90.
(3) The costs will be grouped into
Metropolitan Statistical Areas (MSAs) according to the location of the nursing
facility.
(4) An average room and
board per diem will be calculated for each group.
(5) A wage index appropriate to each MSA will
be applied to the average room and board per diem to account for area
differences in wages.
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