WSR 12-14-094




[ Filed July 3, 2012, 8:15 a.m. ]

Notice of Interpretive or Policy Statement

In accordance with RCW 34.05.230, following is a list of policy and interpretive statements issued by the department of social and health services.

Aging and Disability Services Administration

Division of Management Services

Document Title: SPA Notice.

Subject: Preliminary notice of changes to state of Washington nursing facility medicaid payment rate methodology.

Effective Date: July 2, 2012.

Document Description: To comply with 42 U.S.C. 1396a (a)(13)(A), for all material changes to the methodology for determining nursing facility medicaid payment rates and requiring a Title XIX state plan amendment submitted to and approved by the Centers for Medicare and Medicaid Services (CMS), the department of social and health services (hereafter, department) must publish the proposed new methodologies for determining the payment rates and the underlying justifications.

On May 2, 2012, the governor signed 3ESHB 2127, the state's supplemental operating budget. 3ESHB 2127 became chapter 7, Laws of 2012 2nd sp. sess. The bill had an emergency clause, and was effective on May 2, 2012.

Section 206 of 3ESHB 2127 clarified how the department is to calculate both the "comparative add-on" and the "acuity add-on" when setting July 1, 2012, medicaid rates for nursing facilities. The legislation directed the department to exclude the "comparative add-on" and the "acuity add-on" themselves, as well as the "safety net assessment" reimbursement when computing the July 1, 2012, rates of facilities under chapter 74.46 RCW as part of the comparison of that rate to the rate in effect June 30, 2010.

This clarification is part of an amendment to the state medicaid plan that the department is filing with the federal CMS. In addition to this clarification, the state plan amendment will include other changes to the state medicaid plan:

Updating the "effective date" of the plan, and the reference date for state laws and rules, from July 1, 2011, to July 1, 2012.
Deleting references based on the possibility that the state's request for a waiver in relation to the "safety net assessment" might be denied. The waiver was granted.
Adding a reference to the new "swing bed" rate of $173.38 for SFY 2013.
Deleting material that is now superfluous, including references to previously-repealed statutes, references to rates paid in prior years, and a reference in the section on Proportionate Share Payments for Nursing Facilities Operated by Public Hospital Districts (ProShare). The latter reference is to be removed to clarify that ProShare is an ongoing, open-ended program.

Persons or organizations that have comments on these changes may contact Edward Southon, Manager, Nursing Home Rates, Aging and Disability Services Administration, P.O. Box 45600, Olympia, WA 98504-5600, or

To receive a copy of the interpretive or policy statements, contact Edward Southon, Nursing Home Rates, Aging and Disability Services Administration, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-2469, TDD/TTY 1-800-422-3263, fax (360) 725-2641, e-mail

Washington State Code Reviser's Office