Ch. 7, § 13. Per Diem Rate Period

(a) A nursing facility's per diem rate is effective on July 1 of each year and may be adjusted quarterly in accordance with its acuity case mix. (b) A per diem rate is in effect until the Department sets a new per diem rate which, in addition to a quarterly acuity case mix adjustment, may be the result of a desk review, field audit, change in federal or state law that causes an increase in healthcare costs, or legislative budget change. (c) The data used to calculate the per diem rate effective each July 1 is from the cost reporting period that ended two calendar years prior. (d) The Department will notify nursing facilities of the per diem rate. (e) If the Department sets an interim per diem rate, any amounts the Department paid which exceed the final per diem rate are overpayments and recoverable by the Department. If the interim per diem rate is less than the final per diem rate, the Department will pay the difference to the nursing facility within sixty days. (f) For any nursing facility operated under Public Law 93-638 status, payment is solely a per diem rate established and updated annually per the percentage increase from the published OMB rate from the applicable year. Nursing facilities operated under Public Law 93-638 must still submit a cost report unless the Department notifies the nursing facility that it is no longer necessary.