WSR 05-11-106

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

[ Filed May 18, 2005, 11:05 a.m. ]


NOTICE OF CHANGES TO STATE OF WASHINGTON

NURSING FACILITY MEDICAID PAYMENT RATE METHODOLOGY



The 2005 state legislature has passed changes to the method for determining facility-specific, per resident day Medicaid payment rates for nursing facility care in Washington. Unless otherwise indicated the changes are effective July 1, 2005. This notice includes a justification, description, and estimated rate impact of the changes.

Please address any comments or questions concerning the changes to Edward H. Southon, Department of Social and Health Services, Aging and Disability Services Administration, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-2472, fax (360) 493-9484. Comments should be submitted within fourteen days after appearance of this notice.


JUSTIFICATION


The changes are mandated by the 2005 Washington state legislature in sections 206, 209, and 1109 of ESSB 6090, the State Operating Budget Appropriations Act. ESSB 6090 was passed by the house of representatives and senate on April 24, 2005, and signed by the governor on May 17, 2005.


NEW RATES AND PROPOSED CHANGES TO RATE METHODOLOGY


In combination with a variety of other factors, including changes in the allowed costs of care, the methodological changes are estimated to result in a statewide average nursing facility Medicaid payment rate of $149.14 per resident day, at a maximum, for the state fiscal year 2006, running from July 1, 2005, to June 30, 2006, and $153.50 for fiscal year 2007, running from July 1, 2006, to June 30, 2007.

These figures include adjustments for economic trends and conditions applied to the direct care, therapy care, support services and operations component rates established in accordance with chapter 74.46 RCW for all nursing facilities. The adjustment effective July 1, 2005, is an increase of 1.3%. The adjustment effective July 1, 2006, is also an increase of 1.3%.

The figure of $149.14 per resident day for state fiscal year 2006 represents an increase of $1.03 per resident day over the average facility rate of $148.11, at a maximum, as of June 30, 2005.

Section 209, subsection (6), of ESSB 6090 provides $6,000,000 for supplemental payments to nursing homes operated by public hospital districts in the biennium including state fiscal years 2006 and 2007. These payments are supplemental to payments calculated in accordance with part E of chapter 74.46 RCW. Costs to improve access to healthcare at nursing homes operated by public hospital districts shall not be disallowed solely because such costs were paid by revenues retained by the nursing homes from these supplemental payments.

Section 1109 of ESSB 6090 amends section 209, chapter 276, Laws of 2004, to clarify the legislature's intent that: (1) Funds provided for payments to nursing homes operated by public hospital districts in state fiscal years 2004 and 2005 were supplemental to payments calculated in accordance with part E of chapter 74.46 RCW; and (2) costs to improve access to healthcare at such nursing homes otherwise allowable under chapter 74.46 RCW should not be disallowed solely because such costs were paid by revenues retained by the nursing homes from these supplemental payments. This amendment is retroactively effective to July 1, 2003.

Washington State Code Reviser's Office