NOTICES
DEPARTMENT OF
PUBLIC WELFARE
Nursing Facility Assessment Program
[36 Pa.B. 4673]
[Saturday, August 19, 2006]This notice announces the proposed amount of the assessment for the Fiscal Year (FY) 2006-2007, explains the proposed methodology for FY 2006-2007 and identifies the estimated aggregate impact on nursing facilities that will be subject to the assessment.
Background
The act of September 30, 2003 (P. L. 169, No. 25) (Act 25)1 , known as the Nursing Facility Assessment Law, directs the Department of Public Welfare (Department) to ''implement a monetary assessment'' on nonpublic licensed nursing facilities beginning July 1, 2003, and ending June 30, 2007 (Assessment Program). See sections 802-A and 815-A of Act 25 (62 P. S. §§ 802-A and 815-A). Act 25 further specifies that the Department may implement an Assessment Program ''only to the extent that the revenues generated therefrom will qualify as the State share of [Medical Assistance] program expenditures eligible for Federal financial participation.'' See section 803-A of Act 25 (62 P. S. § 803-A). To guarantee that the assessment amounts qualify for matching Federal funds, Act 25 directs the Department to seek such waivers from the Federal Centers for Medicare and Medicaid Services (CMS) as may be necessary to implement the Assessment Program in conformity with Federal law. See section 812-A of Act 25 (62 P. S. § 812-A). The Department submitted a waiver request to CMS, and CMS subsequently granted the waiver and approved implementation of the Assessment Program.
For each fiscal year that the Assessment Program is implemented, the Secretary of the Department (Secretary), in consultation with the Secretary of the Budget, must determine the aggregate amount of the assessment and the annual assessment rate. The aggregate amount and rate of assessment must be approved by the Governor's Office. The annual assessment rates must be sufficient to generate at least $50 million in additional revenue, subject to the maximum aggregate assessment amount that qualifies for Federal matching funds. See section 804-A of Act 25 (62 P. S. § 804-A).
Before implementing the Assessment Program in a fiscal year, the Secretary must publish a notice in the Pennsylvania Bulletin that specifies the amount of the assessment being proposed, provides an explanation of the assessment methodology and assessment amount and identifies the aggregate impact on nursing facilities subject to the assessment. See section 805-A of Act 25 (62 P. S. § 805-A). This notice announces the assessment amounts, rates and methodology that the Department is proposing to implement in FY 2006-2007 and the estimated aggregate impact on nursing facilities that will be subject to the assessment in FY 2006-2007.
Assessment Methodology, Rates and Amounts
During FY 2006-2007, the Department is proposing to maintain the same assessment methodology that is being used in FY 2005-2006.
More specifically, the following nursing facilities will continue to be exempt from the Assessment Program in FY 2006-2007:
(1) Government owned and operated nursing facilities.
(2) Veteran's Administration nursing facilities.
(3) Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter in which an assessment is collected.
(4) Nursing facilities that provide nursing facility services free of charge to all residents.
Additionally, as in the first 3 years of the Assessment Program, each nonexempt nursing facility will be assessed on a quarterly basis at one of two assessment rates, depending on the number of licensed beds in the facility and the nursing facility's CCRC status. Each nonexempt facility's quarterly assessment amount will continue to be calculated by multiplying its assessment rate by the facility's non-Medicare resident days during the calendar quarter that immediately precedes the assessment quarter.
Although the Department is maintaining the same assessment methodology for FY 2006-2007, the Department is proposing to increase the assessment rates for nonexempt nursing facilities. More specifically, the Department is proposing to implement the following assessment rates during FY 2006-2007:
(1) The assessment rate for nonexempt nursing facilities that participate within a licensed CCRC or that have 50 licensed beds or less will be $1.97 per non-Medicare resident day.
(2) The assessment rate for all other nonexempt nursing facilities will be $20.35 per non-Medicare resident day.
In determining the proposed rate for FY 2006-2007, the Department examined both the projected assessment costs that would be imposed under different rate structures and the estimated additional payments to nursing facilities that could be made as result of the additional assessment revenues. The Department then compared those costs and payments against the costs and payments for the prior fiscal period. Based on the projections and the comparison to the prior fiscal period, the Department determined that the proposed rate increases will best enable the Assessment Program to continue to achieve its intended purpose. First, the increased rates will enable the Assessment Program to collect additional State and Federal funding that is essential to ensure that MA recipients continue to have access to medically necessary nursing facility services as required by law. Second, the additional State and Federal funding collected through the Assessment Program as a result of the increased rates will enable the Department to continue to minimize the number of nursing facilities adversely impacted by the assessment and the extent of the impact.
Aggregate Assessment Amounts and Fiscal Impact
The Department estimates that the annual aggregate assessment fees for nonexempt nursing facilities will total $339,839,170 for FY 2006-2007. All of the revenue derived from the assessment fees and associated Federal matching funds will be used to make payments to qualified Medical Assistance nursing facility providers in accordance with applicable law and regulations.
Public Comment
Interested persons are invited to submit written comments regarding the contents of this notice to Gail Weidman, Chief, Program Analysis and Review Section, Department of Public Welfare, Division of Long-Term Care Client Services, P. O. Box 2675, Harrisburg, PA 17105. Comments must be submitted within 30 days of publication of the notice. See section 805-A of the Act 25. After considering the comments, the Secretary will publish a second notice announcing the final assessment rate for FY 2006-2007. The Department will not begin collecting assessment fees until after the publication of the final assessment rate notice.
Persons with a disability who require an auxiliary aid or service may submit comments using the AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
ESTELLE B. RICHMAN,
SecretaryFiscal Note: 14-NOT-484. No fiscal impact; (8) recommends adoption. Performing the assessment associated with this notice is expected to generate revenue of $339.839 million in Fiscal Year 2006-2007.
[Pa.B. Doc. No. 06-1645. Filed for public inspection August 18, 2006, 9:00 a.m.] _______
1 Act 25 is codified in Article VIII-A of the Public Welfare Code, 62 P. S. §§ 801-A--815-A. 3
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