NH Medicaid Cost Report Due mid-July

Data reported on nursing home Medicaid cost reports are increasingly likely to have an implication on reimbursement. Homes that file late will forego fifteen points on the Nursing Home Quality Initiative (NHQI) score calculation: five for timely, certified and complete submission of the report and five each for two staffing-related measures that rely on cost report data. These include the percentage of contract or agency staff used, as well as an annualized staffing hours measure calculated using cost report figures adjusted for case-mix and predicted staffing hours using the MDS. This will be the first year that cost report staffing data will be used to calculate the staffing measure in place of the CMS 5-star calculation. In addition, eligibility for last year's nursing home Advanced Training Initiative (ATI) funding was largely based on information reported on the staff turnover schedule. It is likely that this year's funding will be tied to this data as well.  

The 2015 RHCF Medicaid cost report and all required certifications are due on July 15, 2016, for homes who file on a calendar year basis and Oct. 31, 2016, for those who file on a fiscal year basis. As in previous years, the Department of Health is stressing that extension requests will not be considered and that staff will be unable to process last minute Health Commerce System (HCS) access requests. It is very important that members arrange HCS access for individuals involved in filing and certifying the cost report well in advance of the due date to ensure that the report is filed on time. The cost report software is available on the HCS and the accompanying Dear Administrator Letter can be accessed here.

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