Pennsylvania Code
Title 55 - HUMAN SERVICES
Part VIII - Intellectual Disability and Autism Manual
Subpart C - Administration and Fiscal Management
Chapter 6211 - ALLOWABLE COST REIMBURSEMENT FOR NON-STATE OPERATED INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY
WAIVER OF STANDARD INTERIM PER DIEM RATE
Section 6211.31 - Request for waiver

Universal Citation: 55 PA Code ยง 6211.31

Current through Register Vol. 54, No. 44, November 2, 2024

(a) To request additional funds for the fiscal year, the provider shall submit a request for a waiver of the standard interim per diem rate in accordance with the requirements of this section. A request can only be submitted if one or more of the following conditions exist:

(1) The facility has been certified as an ICF/ID for less than 18 months prior to the closing date of the most recently submitted cost report.

(2) There has been an increase or decrease in the certified capacity of a facility during the current fiscal year.

(3) An increase or decrease in the certified capacity is anticipated for the next fiscal year.

(4) The characteristics of a client have changed significantly causing significant program changes, resulting in demonstrably different costs.

(5) An unforeseen circumstance has resulted in demonstrably different costs.

(6) The facility has changed ownership.

(b) The request for waiver shall be submitted to the Department in writing by October 31 of the fiscal year for which the waiver is being requested.

(c) A waiver request may not be submitted for more than 1 fiscal year at a time.

(d) If there is an unforeseen circumstance that affects the providers' cost, the request for waiver shall occur during the current fiscal year. The provider shall request a budget review in writing immediately after the change occurs.

(e) A written request for a waiver of the standard interim per diem rate shall include all of the following:

(1) Identification of the specific condition in subsection (a) that exists.

(2) A proposed budget and a proposed per diem rate, on forms and in accordance with the budget instructions prescribed by the Department.

(3) A detailed profile of the providers' costs prior to and after the change.

(4) Detailed justification for the waiver.

(5) The fiscal year for which the waiver is being requested.

(f) For a provider with less than a 12-month cost report who does not submit a request for waiver of the standard interim per diem rate based under subsection (a)(1), an interim per diem rate will be established based upon § 6211.15 (relating to failure to submit cost report).

The provisions of this §6211.31 amended under sections 201(2), 403(b) and 403.1 of the Human Services Code (62 P.S. §§ 201(2), 403(b) and 403.1).

This section cited in 55 Pa. Code § 6211.121 (relating to submission of the budget).

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