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PA Bulletin, Doc. No. 08-191



Payments to County Nursing Facilities; Final Rates for State Fiscal Year 2007-2008

[38 Pa.B. 668]
[Saturday, February 2, 2008]

Purpose of Notice

   The purpose of this notice is to announce the Department of Public Welfare's (Department) final annual rates for State Fiscal Year (FY) 2007-2008, for county nursing facilities that participate in the Medical Assistance (MA) Program.

   The rates are calculated in accordance with 55 Pa.Code Chapter 1189, Subchapter D (relating to rate setting). As stated at 55 Pa. Code § 1189.91(b) (relating to per diem rates for county nursing facilities), for each rate year beginning on or after July 1, 2007, the per diem rate paid to a county nursing facility for a rate year will be the facility's prior rate year per diem rate multiplied by a budget adjustment factor (BAF). The proposed annual per diem rates for FY 2007-2008, were previously announced at 37 Pa.B. 5573 (October 13, 2007).

   As required by § 1189.91(d), the Department followed the formula set forth in the Commonwealth's approved State Plan to determine that the BAF for FY 2007-2008 for county nursing facilities is 1.03. The Federal Centers for Medicare and Medicaid Services approved State Plan amendment 07-008 on September 5, 2007.

   The BAF for rate setting year 2007-2008 shall limit the estimated aggregate increase in the Statewide day-weighted average payment rate for MA nursing facility services for county and nonpublic nursing facilities over the 3 year period commencing July 1, 2005, and ending June 30, 2008, from the Statewide day-weighted average payment rate for MA nursing facility services for county and nonpublic nursing facilities in rate year 2004-2005 to 10.12%. The formula for this BAF as it applies to county nursing facilities is BAF = 1.00 + 0.03.

   The final per diem rates for FY 2007-2008 are available on the website for the Office of Medical Assistance Programs at and at local county assistance offices throughout the Commonwealth or by contacting Tom Jayson, Policy Unit, Office of Long-Term Living at (717) 705-3705.

Public Process

   The Department published a notice announcing its proposed county per diem payment rates for FY 2007-2008 at 37 Pa.B. 5573 (October 13, 2007) and invited interested persons to submit comments. No comments were received by the Department in response to the proposed rates notice.


   Following publication of this notice, the Department will send rate letters to each county MA nursing facility to notify the facilities of their final rates for FY 2007-2008. The rate letter will also advise the facility that it may file an administrative appeal if the facility believes that the Department made any errors or otherwise disagrees with its final rates for FY 2007-2008. A provider's appeal must be in writing and filed with the Department's Bureau of Hearings and Appeals, P. O. Box 2675, Harrisburg, PA 17105, within 33 days of the date of the Department's letter notifying the facility of its final rates. Facilities should refer to 67 Pa.C.S. Chapter 11 (relating to medical assistance hearings and appeals), and to the Department's regulations in 55 Pa. Code Chapter 41 (relating to Medical Assistance provider appeal procedures), for more detail regarding their appeal rights and the requirements related to their written appeals.

Fiscal Impact

   The change in county nursing facility payment rates, effective July 1, 2007, is estimated to cost the Department $17.251 million ($7.908 million in State funds) in FY 2007-2008.

Public Comment

   Interested persons are invited to submit written comments regarding the final rates for FY 2007-2008 to the Department of Public Welfare, Office of Long-Term Living, Attention: Gail Weidman, P. O. Box 2675, Harrisburg, PA 17105. 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 AT&T Relay Services at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).


   Fiscal Note: 14-NOT-540. (1) General Fund; (2) Implementing Year 2007-08 is $7,908,000; (3) 1st Succeeding Year 2008-09 is $8,627,000; 2nd Succeeding Year 2009-10 is $8,627,000; 3rd Succeeding Year 2010-11 is $8,627,000; 4th Succeeding Year 2011-12 is $8,627,000; 5th Succeeding Year 2012-13 is $8,627,000; (4) 2006-07 Program-- $685,279,000; 2005-06 Program--$817,890,000; 2004-05 Program--$476,116,000; (7) Medical Assistance--Long-Term Care; (8) recommends adoption. Funds have been included in the budget to cover these increases.

[Pa.B. Doc. No. 08-191. Filed for public inspection February 1, 2008, 9:00 a.m.]

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