Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1187 - Nursing Facility Services
Subchapter H - PAYMENT CONDITIONS, LIMITATIONS AND ADJUSTMENTS
Section 1187.107 - Limitations on resident care and other resident related cost centers

Universal Citation: 55 PA Code § 1187.107

§ 1187.107. Limitations on resident care and other resident related cost centers

(a) The Department will set a limit on the resident care peer group price for each nursing facility for each year, using the NIS database as specified in § 1187.91 (relating to database), to the lower of:

(1) The nursing facility resident care peer group price.

(2) One hundred three percent of the nursing facility's average case-mix neutralized resident care cost per diem plus 30% of the difference between the 103% calculation and the nursing facility resident care peer group price.

(b) The Department will set a limit on the other resident related peer group price for each nursing facility for each base year, using the NIS database as specified in § 1187.91 to the lower of:

(1) The nursing facility other resident related peer group price.

(2) One hundred three percent of the nursing facility average other resident related cost per diem plus 30% of the difference between the 103% calculation and the nursing facility other resident related peer group price.

(See the first section of this Title for historical and other information)
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