Capital Cost Reimbursement Update

As most members are aware, DOH (per regulation) imputes a 90% occupancy requirement to skilled nursing facilities in calculating their capital rate component. The upcoming 2022 capital rate will utilize 2020 patient days, and thus for a majority of providers, will result in occupancy rates well below the 90% threshold due to COVID-19 census reductions. This in turn would result in a cut in capital reimbursement. NYSHFA recognizes this impact, and together with LeadingAge and HANY’s sent a letter (attached) to the acting Medicaid Director, as well as other DOH officials to seek immediate relief from this regulatory provision.

DOH has acknowledged the issue but noted any regulatory change would be subject to approval in the upcoming Executive Budget cycle. We have responded that previous emergency regulations are often issued by DOH in advance of the budget cycle. NYSHFA will keep members informed as discussions with DOH continue.

NYSHFA/NYSCAL CONTACTS:

Carl J. Pucci
Chief Financial Officer
518-462-4800 x36