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RHCF Medicaid Cost Report Is Due Aug. 9th

We remind nursing home members that the Residential Health Care Facility (RHCF) Medicaid cost report is due Aug. 9th. Please be aware that the “70/40” minimum spending requirements are likely to be applied to 2022 facility spending (i.e., homes that fail to spend 70 percent of their revenue on direct resident care and 40 percent on “resident-facing” staff may be subject to penalties). A bill that passed both houses of the Legislature but is yet to be signed by the Governor would exclude capital revenue from the calculation.

That same legislation would enact a demonstration program allowing homes that utilize 10 percent or less of agency staff to only have Medicaid revenue, rather than all revenue, considered when compliance with 70/40 minimum spending requirements is examined. Additionally, specified percent decreases in reliance on contract staff would reduce the penalties that homes would otherwise face for failing to meet 70/40 requirements. Note that our understanding is that while the capital carve-out would be effective once the bill is signed, the demonstration provisions would start with reporting year 2023.

Nursing home providers should recall that use of third-party cost report software is NOT acceptable. Completing the cost report in third-party software and then loading the data into the Department of Health's (DOH) software may cause an error. If the cost report does not load correctly, it will be deemed unsubmitted by DOH, and the provider may be subject to penalty.

The Dear Administrator Letter (DAL) is available here. We urge members, especially those with new administrators or financial staff, to ensure that they have the necessary permissions in place to allow for the timely submission and certification of the cost report.

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