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PA Bulletin, Doc. No. 19-1487



Payment for Nursing Facility Services Provided by Nonpublic Nursing Facilities Located in a County of the First Class; Nonpublic Nursing Facility Supplementation Payment for Fiscal Year 2019-2020

[49 Pa.B. 5766]
[Saturday, October 5, 2019]

 This announcement provides advance notice that the Department of Human Services (Department) intends to continue to make an additional payment to certain nonpublic nursing facilities in a county of the first class in Fiscal Year (FY) 2019-2020 to ensure access to necessary nursing care in that county.

Proposed Payment

 The Department intends to make a nonpublic nursing facility supplementation payment to each qualified nonpublic nursing facility. To qualify, a nonpublic nursing facility must be located in a county of the first class, have more than 395 beds and a Medicaid acuity of 1.13 as of August 1, 2018. The number of beds will be the number of licensed beds as of August 1, 2018, and the Medicaid acuity will be determined using the Case Mix Index Report for the August 1, 2018, Picture Date in accordance with 55 Pa. Code § 1187.33 (relating to resident data and picture date reporting requirements).

 The Department will calculate the payment to qualifying facilities by multiplying the supplementation per diem by the number of paid Medical Assistance (MA) facility and therapeutic leave days for the prior fiscal year. The supplementation per diem will be calculated by dividing the total funds available by the total number of paid MA facility and therapeutic leave days for the prior fiscal year for qualifying facilities.

 The Department will submit a State Plan Amendment (SPA) to the Centers for Medicare & Medicaid Services (CMS). If CMS approves the SPA, the total funds will consist of both State and Federal funding. The Department will use its best efforts to process this supplementation payment within 30 days of the date it receives notice from CMS.

Fiscal Impact

 This change will result in a cost of $2.094 million ($1.000 million in State funds) for FY 2019-2020.

Public Comment

 Interested persons are invited to submit written comments regarding the nonpublic nursing facility supplementation payment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Marilyn Yocum, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments received within 30 days will be reviewed and considered for any subsequent revision of the notice.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).


Fiscal Note: 14-NOT-1360. (1) General Fund; (2) Implementing Year 2019-20 is $1,000,000; (3) 1st Succeeding Year 2020-21 through 5th Succeeding Year 2024-25 are $0; (4) 2018-19 Program—$850,149,000; 2017-18 Program—$1,099,000,000; 2016-17 Program—$1,082,000,000; (7) Long Term Care; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 19-1487. Filed for public inspection October 4, 2019, 9:00 a.m.]

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