Md. Code Regs. 10.09.10.09-2

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.10.09-2 - Rate Calculation - Other Patient Care Costs for Rates Effective January 1, 2015

A. The Other Patient Care cost center includes:

(1) Medical director administrative expenses;

(2) Pharmacy;

(3) Recreational activities;

(4) Patient care consultant services;

(5) Food cost (unprepared);

(6) Social services; and

(7) Religious services.

B. The Department shall initially establish Other Patient Care prices for the rate period January 1, 2015, through June 30, 2015, and thereafter rebase the Other Patient Care prices between every 2 and 4 rate years. Prices may be rebased more frequently if the Department determines that there is an error in the data or in the calculation that results in a substantial difference in payment, or if a significant change in provider behavior or costs has resulted in payment that is inequitable across providers. The Department shall rebase based on the following steps:

(1) The indexed costs shall be calculated as set forth in Regulation .08-1B(1)-(3) of this chapter;

(2) Each cost report's indexed Other Patient Care costs shall be divided by the actual days of nursing facility services to arrive at the Other Patient Care cost per diem;

(3) For each reimbursement class, each cost report's Medicaid resident days shall be used in the array of Other Patient Care cost per diems identified in §B(2) of this regulation to calculate the Other Patient Care Medicaid day weighted median using the method established in Regulation .08-1B(5) of this chapter;

(4) The final price for Other Patient Care costs for each reimbursement class is calculated as the geographic regional Medicaid day weighted median multiplied by 1.07; and

(5) For years between periods when the prices are rebased, the final price for Other Patient Care costs shall be calculated as set forth in Regulation .08-1D of this chapter.

C. The final Other Patient Care rate for each nursing facility is the Other Patient Care price for its reimbursement class.

D. The reimbursement classes for the Other Patient Care cost center are specified under Regulation .24B of this chapter.

E. Kosher Kitchen Add-on.

(1) Nursing facilities that maintain kosher kitchens and have Other Patient Care costs in excess of the Other Patient Care price in its reimbursement class that are attributable to food costs shall receive an add-on to its final price an amount up to 15 percent of the median per diem cost for food costs in its reimbursement class.

(2) For years between periods when the kosher kitchen add-ons are rebased, the kosher kitchen add-on shall be calculated as the prior year kosher kitchen add-on multiplied by the rate year monthly index divided by the prior year monthly index as identified in Regulation .08-1B(3)(a) of this chapter.

Md. Code Regs. 10.09.10.09-2

Regulations .09-2 amended as an emergency provision effective January 14, 1992 (19:3 Md. R. 299); emergency status expired June 30, 1992
Regulations .09-2 amended as an emergency provision effective July 1, 1992 (19:14 Md. R. 1272); amended permanently effective November 1, 1992 (19:21 Md. R. 1891)
Regulations .09-2 amended as an emergency provision effective July 1, 2005 (32:19 Md. R. 1584); emergency status expired August 31, 2005
Regulations .09-2 amended as an emergency provision effective October 1, 1999 (26:23 Md. R. 1775); adopted permanently effective January 9, 2000 (26:27 Md. R. 2015)
Regulations .09-2 amended as an emergency provision effective December 1, 2001 (29:1 Md. R. 17)
Regulations .09-2 amended as an emergency provision effective July 1, 1995 (22:15 Md. R. 1114); emergency status expired November 1, 1995; amended permanently effective November 6, 1995 (22:22 Md. R. 1658)
Regulations .09-2 amended as an emergency provision effective July 1, 1996 (23:15 Md. R. 1081); amended permanently effective November 4, 1996 (23:22 Md. R. 1496)
Regulations .09-2 amended as an emergency provision effective July 1, 1997 (24:16 Md. R. 1149) (Emergency provisions are temporary and not printed in COMAR)
Regulations .09-2 amended as an emergency provision effective July 1, 1998 (25:15 Md. R. 1181); amended permanently effective October 19, 1998 (25:21 Md. R. 1574)
Regulations .09-2 amended as an emergency provision effective July 1, 1999 (26:16 Md. R. 1237 and 26:18 Md. R. 1369); emergency status expired September 30, 1999
Regulations .09-2 adopted effective 42:7 Md. R. 567, eff.4/13/2015; amended effective 45:13 Md. R. 664, eff. 7/2/2018