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Nursing Home Cost Reports Due July 16th

The Department of Health (DOH) has updated nursing home Medicaid rates effective July 1st and has posted the associated rate sheets on the Health Commerce System (HCS). The update incorporates the January 2018 picture date-based Case Mix Index (CMI) into the rates. The Dear Administrator Letter (DAL) that was posted with the rates is available here, and the DOH email announcement is copied below. Please note that DOH will no longer announce case mix “picture dates” in advance and is in the process of forming a workgroup to discuss how to achieve the CMI-related Medicaid savings required by the enacted state budget. As a result, it is not known whether and which census rosters and MDS assessments might be used to calculate the next CMI update.

Although not mentioned in the DAL, DOH has updated the assessment reimbursement per-diem amount paid through fee-for-service Medicaid from the 2014 reconciled amount to the 2016 reconciled amount. This adjustment, retroactive to Jan. 1, 2018, will be reflected in payment cycle 2131, scheduled for release on July 11th.

Please keep in mind that 2017 Medicaid cost reports are due Mon., July 16th. Members should make all possible efforts to ensure that the report, associated certifications, and any other required materials are submitted by the due date. Failure to do so will result in a lower Nursing Home Quality Initiative (NHQI) score and potential penalties. Some homes have experienced problems with the cost report resulting in all work being lost when edits are run. DOH recommends that those working with the RHCF software save a backup copy of the cost report data file in a different location prior to running edits. It appears that those who do encounter the problem are successful in the second attempt to run edits and save the report.

DOH is asking that any final requests for HCS access for operator and CPA certifications be submitted to rhcf-hcs@health.ny.gov by Thurs., July 12th to help ensure timely submission of the report and certifications by July 16th.

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


From: doh.sm.BLTCR.NF.RATES [mailto:nfrates@health.ny.gov]
Sent: Friday, July 6, 2018 12:59 PM
Subject: July 1, 2018 Case Mix Rates

This notification is to provide you information about your residential health care facility (RHCF) Medicaid reimbursement rates for the period commencing July 1, 2018

The all-inclusive rates and Dear Administrator letter are provided on Health Commerce System (HCS) and include an update to include the January 2018 Case Mix Collection.

Please email the Department at NFRATES@health.ny.gov if you have any questions regarding the rate. Please include “January Census July Rates” in the subject line. Also include the following information when you submit an inquiry: Opcert number, agency name and contact information