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PA Bulletin, Doc. No. 21-300



Payment for Nursing Facility Services Provided by a Special Rehabilitation Facility Located in a County of the First Class; Special Rehabilitation Facility Payment for Fiscal Year 2020-2021

[51 Pa.B. 1091]
[Saturday, February 27, 2021]

 This announcement provides advance notice that the Department of Human Services (Department) intends to make an additional payment to certain nonpublic nursing facilities in a county of the first class in Fiscal Year (FY) 2020-2021 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 special rehabilitation facility in Peer Group number 13 must be located in a county of the first class, have more than 55 beds and a Medicaid acuity of 1.43 as of May 1, 2020. The number of beds will be the number of licensed beds as of May 1, 2020, and the Medicaid acuity will be determined using the Case Mix Index Report for the May 1, 2020, Picture Date in accordance with 55 Pa. Code § 1187.33 (relating to resident data and picture date reporting requirements).

 The Department will calculate the FY 2020-2021 add-on payment to qualified nursing facilities by dividing the total funds for the supplemental payment by the number of qualified nonpublic nursing 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 an estimated cost of $843 thousand ($351 thousand in State funds) for FY 2020-2021.

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: Montrell Fletcher, 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-1427. (1) General Fund; (2) Implementing Year 2020-21 is $351,000; (3) 1st Succeeding Year 2021-22 through 5th Succeeding Year 2025-26 are $0; (4) 2019-20 Program—$470,244,000; 2018-19 Program—$850,149,000; 2017-18 Program—$1,099,000,000; (7) Long-Term Care; (8) recommends adoption. Funds have been included in the budget to cover this increase.

[Pa.B. Doc. No. 21-300. Filed for public inspection February 26, 2021, 9:00 a.m.]

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