NOTICES
DEPARTMENT OF
HUMAN SERVICES
Nursing Facility Assessment Program for Fiscal Year 2019-2020
[50 Pa.B. 999]
[Saturday, February 15, 2020]This notice announces the amount of the assessment that the Department of Human Services (Department) is implementing for Fiscal Year (FY) 2019-2020, provides an explanation of the assessment methodology that the Department is using in FY 2019-2020 and identifies the estimated aggregate impact on nursing facilities which will be subject to the assessment.
Background
Article VIII-A of the Human Services Code (code) (62 P.S. §§ 801-A—815-A) authorizes the Department to impose an annual monetary assessment on nursing facilities and county nursing facilities in this Commonwealth each fiscal year through FY 2021-2022. Under Article VIII-A of the code, the Department may impose the assessment only to the extent that the assessment revenues qualify as the State share of Medical Assistance (MA) Program expenditures eligible for Federal financial participation (FFP). See 62 P.S. § 803-A. To ensure receipt of FFP, Article VIII-A of the code requires the Department to seek a waiver from the Centers for Medicare & Medicaid Services if necessary to implement the Assessment Program. See 62 P.S. § 812-A.
For each fiscal year that the Assessment Program is implemented, the code authorizes the Secretary of the Department (Secretary) to determine the aggregate amount of the assessment and the annual assessment rate in consultation with the Secretary of the Budget. See 62 P.S. § 804-A. The code specifies that annual assessment rates must be sufficient to generate at least $50 million in additional revenue, but not more than the maximum aggregate assessment amount that qualifies for Federal matching funds. See 62 P.S. § 804-A.
The Secretary must publish a notice in the Pennsylvania Bulletin before imposing an annual assessment for a fiscal year. The notice must specify the amount of the assessment being proposed, explain the proposed assessment methodology, identify the estimated assessment amount and aggregate impact on nursing facilities subject to the assessment and provide interested persons a 30-day period to comment. See 62 P.S. § 805-A.
After consideration of any comments received during the 30-day comment period, the Secretary must publish a second notice announcing the rate of assessment for the fiscal year. See 62 P.S. § 805-A. The annual aggregate assessment amount and assessment rate for the fiscal year must be approved by the Governor. See 62 P.S. § 804-A.
The Secretary published a notice at 49 Pa.B. 3412 (June 29, 2019) announcing the proposed assessment rates, the aggregate amount and the impact for FY 2019-2020. No comments were received by the Department in response to the proposed rates notice.
Assessment Methodology and Rates for FY 2019-2020
The following nursing facilities will continue to be exempt from the Assessment Program in FY 2019-2020:
(1) State-owned and operated nursing facilities.
(2) Veteran's Administration nursing facilities.
(3) Nursing facilities that provide nursing facility services free of charge to all residents.
(4) Newly licensed nursing facilities that have not been licensed and operated by the current or previous owner will be exempt until the nursing facility's days are included in the data used as the basis of the assessment. A nursing facility that changes ownership is not considered a newly licensed nursing facility for assessment purposes.
The Department will continue to assess nonexempt nursing facilities at two rates. One rate will apply to the following five categories of nursing facilities:
• County nursing facilities.
• Nursing facilities that have 44 or fewer licensed beds.
• Certain continuing care retirement community (CCRC) nursing facilities (see 40 Pa.B. 7297 (December 18, 2010)).
• Nursing facilities with an MA occupancy rate of at least 94% based on Calendar Year (CY) 2017 resident days as of November 26, 2018. For the purpose of qualifying for the lower assessment rate, a nursing facility's MA occupancy rate will be calculated as follows: MA Occupancy Rate = Sum of Total PA MA Days from the CY 2017 resident days data ÷ Sum of Total Resident Days from the CY 2017 resident days data, rounded to two decimals.
• Nursing facilities with at least 125,000 MA days and with an overall occupancy rate of 90% or higher based on the CY 2017 resident days as of November 26, 2018. For the purpose of qualifying for the lower assessment rate, a nursing facility's overall occupancy rate will be calculated as follows: Overall Occupancy Rate = Sum of Total Resident Days from CY 2017 resident days as of November 26, 2018 ÷ (number of licensed beds as of November 25, 2018 × 365), rounded to two decimals.
The other rate will apply to all other nonexempt facilities, including nursing facilities that began participation in a CCRC on or after July 1, 2010. Using the applicable rate, the Department will calculate an annual assessment amount for each nonexempt facility by multiplying its assessment rate by the facility's historical non-Medicare resident days for CY 2017. The Department will collect the annual assessment amount in four equal quarterly installments.
Although the Department will maintain essentially the same basic rate structure for FY 2019-2020 as in FY 2018-2019, the Department is decreasing the assessment rates uniformly for nonexempt nursing facilities by $0.10 from last year's rates. For FY 2019-2020, the assessment rates for nonexempt nursing facilities will be as follows:
(1) For county nursing facilities, for nursing facilities that have 44 or fewer licensed beds, for qualified CCRC nursing facilities, nursing facilities with an MA occupancy rate of at least 94% based on CY 2017 resident days as of November 26, 2018, and nursing facilities with at least 125,000 MA days and with an overall occupancy rate of 90% or higher based on the CY 2017 resident days as of November 26, 2018, the assessment rate will be $7.30 per historical non-Medicare resident day.
(2) For all other nonexempt nursing facilities, the assessment rate will be $31.39 per historical non-Medicare resident day.
The Assessment Program due dates are established in accordance with section 1729-E(2)(ii) of the Fiscal Code (72 P.S. § 1729-E(2)(ii)) regarding the Department of Human Services and will be available on the Department's web site at http://www.dhs.pa.gov/providers/Providers/Pages/Long-Term-Nursing-Facilities.aspx.
Aggregate Assessment Amounts and Fiscal Impact
The Department estimates that the annual aggregate assessment fees for nonexempt nursing facilities will total $489.855 million. The Department will use the State revenue derived from the assessment fees and any associated FFP to support payments to qualified MA nursing facility providers in accordance with applicable laws and regulations.
Public Comment
Interested persons are invited to submit written comments regarding the contents of this notice 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).
TERESA D. MILLER,
SecretaryFiscal Note: 14-NOT-1385. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 20-222. Filed for public inspection February 14, 2020, 9:00 a.m.]
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