048.0037.7.21
Ch. 7, § 21. Nursing Care Facility Assessment Act
Cite as Medicaid Rules, Ch. 7, § 21
(a) Nursing facility adjustment payments to nursing facilities based on the upper payment limit calculation. The Department will make adjustment payments to nursing facilities under the provisions of the Nursing Care Facility Assessment Act, Wyo. Stat. Ann. §§ 42-8-101 through 109.
(i) Adjustment payments will be calculated prospectively on an annual basis to be effective from October 1 through September 30 of each year. The adjustments will be paid quarterly. A new nursing facility opening during that assessment year will not be included in the program until the next assessment year.
(ii) The quarterly adjustment payments will be due to the providers not later than thirty days after the end of each calendar quarter.
(iii) If a nursing facility changes ownership, beginning at the start of the calendar quarter following the date of the change of ownership, the new owner will collect the adjustment payment that was calculated using the prior owner's data. If a nursing facility changes ownership mid quarter, the adjustment payment goes to whoever owns the nursing facility at the end of the quarter.
(iv) Adjustment payments will be calculated based on Medicaid days paid by the Wyoming Medical Assistance Program.
(A) Wyoming Medicaid days will be collected for the dates of service represented in cost reports ended in the calendar year that precedes the assessment effective each October 1. The Medicaid days will be generated by the Department from their MMIS payment system.
(B) For a new nursing facility that opened prior to the October 1 annual calculation that does not have either a full year cost report or a qualifying cost report, resident days will be determined using more current information and will be annualized.
(v) State owned nursing facilities are exempt from this program.
(b) Nursing facility assessment payable to the Department. The Department will collect an assessment from nursing facilities under the provisions of the Nursing Care Facility Assessment Act, W.S. § 42-8-101 through 109.
(i) Assessments will be calculated prospectively on an annual basis to be effective from October 1 through September 30 of each year. The annual assessments will be paid quarterly. A new nursing facility opening during that assessment year will not be included in the program until the next assessment year.
(ii) The quarterly assessments will be due to the Department no later than forty-five days after the end of each calendar quarter.
(iii) If a nursing facility changes ownership, beginning with the quarter following the date of the change of ownership, the new owner will assume the payment schedule calculated using prior owner's data. If it is not clear to the Department which owner is responsible for the assessment, the owner who received the quarterly adjustment payment will be responsible to pay the Department for the assessment related to that same quarter.
(iv) Assessments will be calculated based on a per-resident day basis, exclusive of Medicare resident days.
(A) Resident days will be collected from the Wyoming Nursing Home Reimbursement System, Financial Report for Nursing Homes (cost report) that ended in the calendar year that precedes the assessment effective each October 1. The Department will revise its cost report form to collect the appropriate patient day data. Until the revised cost report forms are in use and have been filed with the Department, the Department will utilize a provider survey to gather the necessary data.
(B) If a new nursing facility opened prior to the October 1 annual calculation that does not have either a full year cost report or a qualifying cost report, resident days will be determined using more current information and will be annualized.
(v) Assessment expenses must be reported on the State of Wyoming Financial Report for Nursing Homes annual cost report. Expenses must be reported on schedule B of this same cost report. For nursing facilities who do not file a Medicare cost report, assessment expenses shall be reported on line 578 of the State of Wyoming Financial Report for Nursing Homes annual cost report.
(vi) State owned facilities are exempt from this program.