Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1181 - NURSING FACILITY CARE
Subchapter B - MANUAL FOR ALLOWABLE COST REIMBURSEMENT FOR SKILLED NURSING AND INTERMEDIATE CARE FACILITIES
REIMBURSEMENT PRINCIPLES
Section 1181.215 - Efficiency incentive
Current through Register Vol. 54, No. 44, November 2, 2024
Subject to the sanctions specified in §§ 1181.91-1181.96 (relating to administrative sanctions), an efficiency incentive will be allowable for a nonpublic facility if the facility's audited net operating per diem costs are less than the applicable group ceiling. In determining the efficiency incentive, the following limitations apply:
(1) Proprietary facilities may receive an efficiency incentive of up to 8.5% of the Statewide average net operating per diem cost of general nursing facilities excluding hospital-based and special rehabilitation facilities for each level of care for the prior fiscal year.
(2) Nonprofit facilities may receive an efficiency incentive of up to 6% of the Statewide average net operating per diem cost of general nursing facilities excluding hospital-based and special rehabilitation facilities for each level of care for the prior fiscal year.
(3) In no event may the total of a facility's audited net operating per diem rate and the efficiency incentive exceed the applicable group ceiling for the facility.
