Chapter 90. Methods and Standards for Establishing Payment Rates for Long-Term CareRead Chapter
- Part I.Read allMethods and Standards for Establishing Payment Rates for Long-Term Care
- Section 10
- Methods and standards for establishing payment rates for long-term care
- Section 11
- Public comment process
- Part II.Read allNursing Home Payment System
Subpart I
General - Section 19
- Supplemental payments for government-owned nursing facilities
- Section 20
- [Repealed]
- Section 21
- Reimbursement for individuals in a disaster struck nursing facility
- Section 28
- Mid-year fair rental value rate determination
- Article 1.Read allTransition to New Capital Payment Methodology
- Section 29
- Transition to new capital payment methodology
- Article 2.Read allPlant Cost Component
- Section 30
- Plant cost
- Section 31
- New nursing facilities and bed additions
- Section 32
- Major capital expenditures
- Section 33
- Financing
- Section 34
- Purchases of nursing facilities (NF)
- Article 3.Read allFair Rental Value Capital Payment System
- Section 35
- General applicability
- Section 36
- Nursing facility capital payment methodology
- Section 37
- Calculation of FRV per diem rate for capital; calculation of FRV rental amount; change of ownership
- Section 38
- Schedule of assets reporting
- Section 39
- Purchases of nursing facilities (NF)
- Article 4.Read allOperating Cost Component
- Section 40
- Operating cost
- Section 41
- Nursing facility reimbursement formula
- Section 42
- [Repealed]
- Section 44
- Nursing facility price-based reimbursement methodology
- Section 45
- Supplemental payments for state-owned nursing facilities
- Section 46
- [Reserved]
- Section 47
- [Reserved]
- Section 48
- [Reserved]
- Section 49
- [Reserved]
- Article 5.Read allAllowable Cost Identification
- Section 50
- Allowable costs
- Section 51
- Purchases/related organizations
- Section 52
- Administrator/owner compensation
- Section 53
- Depreciation
- Section 54
- Rent/Leases
- Section 55
- Provider payments
- Section 56
- Legal fees/accounting
- Section 57
- Documentation
- Section 58
- Fraud and abuse
- Section 59
- [Reserved]
- Article 6.Read allNew Nursing Facilities
- Section 60
- Interim rate
- Section 65
- Final rate and effective for dates of services beginning July 1, 2001, through June 30, 2014
- Article 7.Read allCost Reports
- Section 70
- Cost report submission
- Section 75
- Reporting form; accounting method; cost report extensions; fiscal year changes
- Article 8.Read allProspective Rates
- Section 80
- Time frames
- Article 9.Read allRetrospective Rates
- Section 90
- Retrospective rates
- Section 100
- [Reserved]
- Article 10.Read allRecord Retention
- Section 110
- Record retention
- Article 11.Read allAudits
- Section 120
- Audit overview; scope of audit
- Section 121
- Field audit requirements
- Section 122
- Provider notification
- Section 123
- Field audit exit conference
- Section 124
- Audit delay
- Section 125
- Field audit time frames
- Section 126
- [Reserved]
- Section 130
- [Repealed]
- Section 136
- Elements of capital payment methodology not subject to appeal
- Section 137
- [Reserved]
- Section 140
- Individual expense limitation
- Section 150
- Cost report preparation instructions
- Article 1.Read allPlant Cost Applicable
- Section 160
- Stock acquisition; merger of unrelated and related parties
- Article 2.Read allCapital Cost Applicable
- Section 165
- Stock acquisition; merger of unrelated and related parties
- Section 170
- NATCEPs costs
- Section 180
- Criminal records checks
- Section 190
- Use of MMR-240
- Section 200
- Commingled investment income
- Section 210
- Provider notification
- Section 220
- Start-up costs
- Section 221
- Time frames
- Section 222
- Organizational costs
- Section 223
- [Reserved]
- Section 230
- Access to records
- Section 240
- Home office operating costs
- Section 250
- Lump sum payment
- Section 251
- Offset
- Section 252
- Payment schedule
- Section 253
- Extension request documentation
- Section 254
- Interest charge on extended repayment
- Section 255
- [Reserved]
- Section 257
- Credit balance reporting
- Section 258
- [Reserved]
- Section 260
- [Repealed]
- Section 264
- Specialized care services
- Section 266
- Traumatic Brain Injury (TBI) payment
- Section 267
- Private room differential
- Part III.Read allNursing Home Payment System Appendices
Appendix I
Uniform Expense Classification - Article 2.Read allCapital Cost Applicable
- Section 270
- Uniform Expense Classification
- Section 271
- Direct patient care operating
- Section 272
- Indirect patient care operating costs
- Section 273
- Plant costs
- Section 274
- Nonallowable expenses
- Section 275
- Nurse Aide Training and Competency Evaluation Programs (NATCEPs) costs
- Section 276
- Criminal records background checks
- Section 280
- Leasing of facilities
- Section 290
- Cost reimbursement limitations
- Section 300
- [Repealed]
- Section 305
- Resource Utilization Groups (RUGs)
- Section 306
- Case-mix index (CMI)
- Section 307
- Applicability of case-mix indices (CMI)
- Section 310
- Normalized Case Mix Index (NCMI)
- Section 320
- National RUG-III categories and weights
- Part IV.Read allTraumatic Brain Injury Payment System
- Article 2.Read allCapital Cost Applicable
- Section 330
- Traumatic brain injury diagnoses