Nursing Home Medicaid Rates

DOH intends to make rate adjustments to incorporate the 2013 Nursing Home Quality Initiative recently approved by CMS into Medicaid rates in late November or early December.  The state will issue updated 2013 Medicaid rates reflecting the quality pool amounts and make payment adjustments retroactive to Jan. 1, 2013 by multiplying the per-day figure by 2013 Medicaid days.  The 2013 per-day quality pool adjustment amounts are shown in the "Quality Adjustment" column on the 2014 benchmark rates listing.   

Although no dates have been set, DOH hopes to issue July 2014 rates reflecting the January 2014 case mix soon after that.  Those rates are currently under review by the Division of the Budget.  The 2012 assessment reconciliation and adjustments related to 2012 MDS audits are expected to follow.   The current focus of DOH rate setting staff is making corrections to 2015 capital based on information received from homes last month and finalizing initial 2015 rates for issuance in early November.

Contact:  Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841