Important Dates and Deadlines for Nursing Homes

The Department of Health (DOH) has announced several dates important to nursing homes.  Perhaps the most important ones are related to the Universal Settlement of Litigation and Appeals.  DOH hopes to distribute the final release documents along with facility-specific exclusion lists this week and has announced their intention to hold mass signing events in three areas of the state: the Rochester area on Nov. 30th; the Albany area on Dec. 3rd; and, the New York City area on Nov. 23rd, 24th and 25th. More information and exact locations are listed here. DOH hopes to have all the release documents signed by early December. CMS has provided conceptual approval pending review of final release documents suggesting the first payment would be available once releases are collected.   

Homes seeking to correct the capital component of their 2016 Medicaid rate by submitting and attesting to their own calculation must do so by Dec. 4th.  Homes wishing to do so will have the right to file a traditional appeal of their capital once final rates are published in January. DOH is stressing that homes may only use one method of correcting their 2016 capital rate:  if they file an appeal, any attested calculation that was submitted previously will become void.  DOH reserves the right to reject an attested calculation with which they disagree.  The Office of Medicaid Inspector General (OMIG) will be responsible to verify attested capital calculations through audit.

Last week DOH posted rate sheets on the Health Commerce System showing the operating component of the 2016 Medicaid rate. Please note that the rates shown are calculated using a Case Mix Index (CMI) based on a July 2014 "picture date" and will be eventually updated to reflect a CMI based on the July 2015 "picture date" data.   Last week DOH also formally announced the 2016 "picture dates" (census roster dates) which remain the last Wednesdays of January and July (Jan. 27th and July 27th for 2016). Homes will be required to upload the January roster during the three week period beginnng Mar. 28th.  The three week submission period for the July rosters will begin on Sep. 26th.

Complete nursing home budgeting guidance is available here.

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