Nursing Home Quality Pool Payments On the Way

The Department of Health (DOH) notified nursing home providers on March 7, 2023 that payment adjustments related to the State’s 2021 Nursing Home Quality Initiative (NHQI) will be made in Medicaid rate cycle 2377, with a check release date of March 29, 2023. The NHQI divides nursing homes into quintiles based on their overall score, with payment adjustments dependent on the quintile assignment. This year’s distribution provides approximately 1.3 percent of annual Medicaid revenue to those in the best quintile, 0.8 percent to those in the second, and 0.2 percent to those in the middle quintile. Facilities in the fourth and fifth quintiles will see a negative adjustment equivalent to about 0.8 percent of annual Medicaid revenue. Specialty facilities and Continuing Care Retirement Communities (CCRCs) are excluded from the NHQI.

DOH has posted the backup calculations here, and the Dear Administrator Letter (DAL) with the funding distribution formula is here. The full list of measures and scoring conventions used in the 2021 NHQI is available here.

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