The Florida Agency for Health Care Administration (the Agency), Bureau of Medicaid Program Analysis provides the following public notice regarding reimbursement for nursing home facilities participating in the Florida Medicaid Program.
PURPOSE: To comply with federal public notice requirements in Section 1902(a)(13)(A) of the Social Security Act in changing reimbursement for nursing home facilities, the Agency is publishing the final rates, the methodologies underlying the establishment of such rates, and justifications for the final rates. The Agency has amended its Title XIX Long-Term Care Reimbursement Plan (The Plan) to incorporate changes to the reimbursement methodology.
FINAL RATES: The final rates for the Florida Title XIX Long-Term Care Reimbursement Plan payment methodology effective April 1, 2006 are as follows:
1. The Agency has deleted the low occupancy adjustment for the direct care component of the nursing home reimbursement rate; and
2. The occupancy adjustment for operating and indirect patient care costs shall not result in a reduction of more than 20 percent of the applicable class ceiling.
METHODOLOGIES: The methodology underlying the establishment of the final rates for Medicaid nursing facilities will be rates resulting from the revised methodology used to calculate per diems in the Long-Term Care Reimbursement Plan.
JUSTIFICATION: The justification for the final rate change is to remove occupancy related rate reductions for direct care nursing staff, as the Agency requires minimum staffing requirements on a daily basis. This component of Medicaid nursing home reimbursement is computed separately from other components of the nursing home reimbursement rate, which is different than when the low occupancy adjustment was first included in the Long-Term Care Reimbursement Plan. The direct correlation between minimum staffing requirements and the rate calculation justify the removal of this provision in the direct care component.
Providers, beneficiaries and their representatives, and other concerned state residents may provide written comment on the final rates, methodologies and justification underlying the establishment of such changes. Please submit your comments to the contact person listed below.
Copies of the final reimbursement plan incorporating the above changes are available at this time. Please contact: Edwin Stephens, by mail at Agency for Health Care Administration,