Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 51 Pa.B. 3586 (June 26, 2021).

55 Pa. Code § 6211.16. Establishment of standard interim per diem rate.

§ 6211.16. Establishment of standard interim per diem rate.

 (a)  The standard interim per diem rate shall be used for billing purposes throughout the current fiscal year.

 (b)  The standard interim per diem rate shall be established by dividing the total projected operating cost by 98% of the maximum possible number of days based on the number of certified beds of the facility.

 (c)  The total projected operating cost is derived under the following procedures:

   (1)  Taking the total MA allowable costs, including adjustments for income, and comparing this to the approved budget total, or the total projected operating costs if applicable, for the same fiscal year in order to determine the lesser amount. From the lesser amount, subtract depreciation on capital assets, limited to buildings and fixed equipment, and interest on capital indebtedness.

   (2)  The Department may apply a cost of living adjustment to the interim per diem rate during the rate development process.

   (3)  Adding depreciation on capital assets, limited to buildings and fixed equipment, and interest on capital indebtedness to the total projected cost to result in the total projected operating cost.

 (d)  The cost report submitted by the provider, in addition to adjustments made by the Department, as specified in §  6211.14 (relating to adjustments to cost report), shall be used for the calculation of the standard interim per diem rate.

 (e)  The Department may apply a downward rate adjustment factor to the standard interim per diem rate for each provider to remain within the amount appropriated by the General Assembly, including those providers who request a waiver of the standard interim per diem rate as specified in §  6211.31 (relating to request for waiver). The amount of funds resulting from the application of the rate adjustment factor cannot be requested as a waiver of the standard interim per diem rate as identified under §  6211.31.

Authority

   The provisions of this §  6211.16 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).

Source

   The provisions of this §  6211.16 amended June 8, 2012, effective July 1, 2011, in accordance with section 403.1(e) of the Human Services Code, 42 Pa.B. 3261. Immediately preceding text appears at serial pages (213312) to (213313).

Cross References

   This section cited in 55 Pa. Code §  6211.18 (relating to upper limits of payment if the standard interim per diem rate is used); and 55 Pa. Code §  6211.41 (relating to cost reimbursement).



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