Table IV | ||
Quarter of Provider Cost Report Year End | Picture Dates Used to Neutralize Costs for Ceiling Calculation | |
Preferred Picture Dates if No Data Limitation Applied | Picture Dates That Shall be Used Due to Data Limitation | |
First Quarter of CY 2000 | 3/31/99, 6/30/99, 9/30/99, 12/31/99 | 12/31/99 |
Second Quarter of CY 2000 | 6/30/99, 9/30/99, 12/31/99, 3/31/00 | 12/31/99, 3/31/00 |
Third Quarter of CY 2000 | 9/30/99, 12/31/99, 3/31/00, 6/30/00 | 12/31/99, 3/31/00, 6/30/00 |
Fourth Quarter of CY 2000 | 12/31/99, 3/31/00, 6/30/00, 9/30/00 | 12/31/99, 3/31/00, 6/30/00, 9/30/00 |
Table V Example of Picture Dates Used in Case-Mix Adjustment of Prospective Rate | ||
Quarter of Provider Cost Report Year End | Picture Dates Used to Adjust First Prospective Semiannual Period | Picture Dates Used to Adjust Second Prospective Semiannual Period |
First Quarter CY 2002 | 9/30/01, 12/31/01 | 3/31/02, 6/30/02 |
Second Quarter CY 2002 | 12/31/01, 3/31/02 | 6/30/02, 9/30/02 |
Third Quarter CY 2002 | 3/31/02, 6/30/02 | 9/30/02, 12/31/02 |
Fourth Quarter CY 2002 | 6/30/02, 9/30/02 | 12/31/02, 3/31/03 |
12/31/2001 picture date CMI | 1.0100 |
3/31/2002 picture date CMI | 1.0105 |
6/30/2002 picture date CMI | 1.0098 |
9/30/2002 picture date CMI | 1.0305 |
12/31/2002 picture date CMI | 1.0355 |
3/31/2003 picture date CMI | 1.0400 |
Average Allowable Direct Patient Care Operating Rate | $50 |
Allowance For Inflation FYE 2003 x 1.0400 | $52 |
12/31/2001 CMI | 1.0100 |
3/31/2002 CMI | 1.0105 |
6/30/2002 CMI | 1.0098 |
9/30/2002 CMI | 1.0305 |
Average of four CMI = | 1.0152 |
Case-mix neutralization factor ÷ 1.0152
Case-mix neutralized Direct Patient Care Operating Rate for FY 2003 = $51.22
The case-mix neutralized Direct Patient Care Operating Rate, $51.22, is lower than the case-mix neutral ceiling, $60. $51.22 will be used in the rate calculation.
First semiannual rate adjustment %68 Average of (6/30/2002 CMI, 9/30/2002 CMI) = Average(1.0098,1.0305) = 1.0202
Second semiannual rate adjustment %68 Average of (12/31/2002 CMI, 3/31/2003 CMI) = Average(1.0355,1.0400) =1.0378
First semiannual rate = 1.0202 * $51.22 = $52.25
Second semiannual rate = 1.0378 * $51.22 = $53.15
12 Va. Admin. Code § 30-90-307
Statutory Authority
§ 32.1-325 of the Code of Virginia.