DOH held its Monthly Briefing earlier today. The following summarizes the topics discussed:
- Nursing Homes Reform – Internal DOH conversations continue regarding the nursing home reform issues contained in the 2021/22 Executive Budget. Further guidance will be issued.
- 70/40 Staffing Requirements – NYSHFA has repeatedly requested information and updates on the Department’s promulgation of the 70/40 regulations. A representative from the DOH stated that the 70/40 staffing regulations are currently being developed and the State expects to issue draft regulations during the last two weeks in August, followed by a 60-day public comment period. Although the 70/40 staffing requirements are effective 1/1/22, the 2022 RHCF data utilized for the 70/40 staffing requirement will not be submitted and analyzed until mid to late 2023. As such, financial impacts related to the 70/40 regulations would then be retroactive to 1/1/22.
- July 2021 Case Mix – DOH has issued guidance for its 6-month rolling MDS collection period (Oct 2020 – Mar 2021) utilizing all MDS data points. As you are aware, DOH has been advancing this initiative for some time and this rolling process will replace the historical 92-day look-back period. As such, NYSHFA has continuously stressed to our members that they treat each MDS as if they were in the historical reimbursement “catchment period.” The 7/1/21 DAL outlined the MDS collection period changes. Members should be reviewing their census data currently, as all changes are due by 7/23/21. Final MDS certifications are due by 7/30/21. The DOH webinar held last week and related Q&A’s will be posted to both the HCS and he DOH website in the near future.
- 7/1/21 Rates – Following completion of the MDS collection period (see above) the 7/1/21 rates will be immediately developed. Expect issuance sometime during mid to late September (following the normal DOB approval process).
Provider Restoration Payments
CMS has approved the additional 1% restoration SPA (which had been previously utilized to fund the Universal Settlement payments.) DOH expects to combine the additional 1% restoration, the “traditional” 1% restoration (which will include the “doubling up” for previous retroactive periods) and the 2020 NHQI into one lump-sum package. Providers should expect issuance sometime during 4th Quarter 2021. As such, this should result in a 3% lump sum restoration payment (prior to any offset due to NHQI.)
2020 RHCF Deadline Extended
The deadline for the 2020 RHCF has been extended to Friday, August 20, 2021. In order to ensure sufficient time to complete the necessary reviews for the capital attestation process, there will be no further extensions beyond that date. Members should ensure appropriate access and active connection to the HCS prior to submitting the RHCF and applicable certifications.
The 2020 NHQI calculation, utilizing the 2019 MDS data is nearing completion. The normal provider feedback period will occur over the next 4 – 6 weeks. Work will then commence on the 2021 NHQI calculation (utilizing the 2020 MDS data).
With the conclusion of the litigation, DOH will be restoring residual equity for the named litigants for the period 4/2/20 through 10/7/20. Effective 10/8/20, going forward, the residual equity will then be removed from the rates. The rate package will then move on to DOB for approval.
OMIG MDS Audits
OMIG confirmed that the 2016 MDS audits are now complete. OMIG has a majority of 2017 MDS audits currently in fieldwork and nearing their exit conferences.
Carl J. Pucci
Chief Financial Officer