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DOH Distributes Minimum Spending Survey to Hospital-Based Nursing Homes

The Department of Health (DOH) is seeking to verify eligibility for staffing funding for hospital-based nursing homes. Homes that file the Residential Health Care Facility (RHCF)-2 Medicaid cost report should have received a communication from DOH on April 11th with information and instructions for submitting some additional financial information that will allow the Department to ascertain compliance with minimum spending requirements. Although the mandate that nursing homes spend at least 70 percent on direct care and at least 40 percent on resident-facing staff is not effective until cost year 2022, eligibility for funding that was appropriated in last year’s State Budget to help nursing homes defray some of the cost of nursing staffing level requirements is contingent on homes having met those thresholds in 2020. Free-standing homes that file the RHCF-4 Medicaid cost report and were deemed compliant with minimum spending requirements received funding at the end of March. While the full, all-funds appropriation is $187 million, DOH has agreed to release the State share (i.e., 50 percent) pending federal approval of the program.

The survey is needed because the legislation defines minimum spending requirements using spending thresholds based on RHCF-4 cost report categories. As a result, to get comparable data, the survey asks hospital-based homes to calculate and submit revenue and expense figures based on the categories used in the RHCF-4.

Please note that although the minimum spending statute excludes cash receipts assessment reimbursement, federal COVID-19 relief, and certain capital reimbursement from revenue, DOH has clarified that when completing the survey, these exclusions should NOT be applied:

Q. Should the revenue exclusions specified in 415.34(b)(4) be reflected when revenue is reported on the survey?

DOH Response: Nursing homes should not deduct the revenue exclusions specified in subsections (i), (ii), (iii) and (iv) of 10 NYCRR 415.34(b)(4). Facilities should report Nursing Home Revenues as described in the supplemental instructions provided. Upon receipt of the certified survey, the Department will apply the exclusions as appropriate. As stated in the survey, the Department may request additional information if necessary.

The data must be entered through the Health Electronic Response Data System (HERDS) on the Health Commerce System (HCS) no later than 4 p.m. on May 26th. Please note that while the nursing home administrator may enter data for this survey, the operator of the nursing home or an executive officer with the authority to certify on behalf of the facility must review the data, complete the certification statement, and submit the completed survey. Should you have questions or if you are an RHCF-2-filing nursing home that did not receive the above communication, please let us know. DOH is fielding questions on the survey at NHSafeStaffing@health.ny.gov.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841