One per diem rate shall be established for a facility and paid for every Medicaid-eligible resident in that facility. The State shall have discretion in what it charges non-Medicaid residents. The state will not pay for reserve bed days in state institutions. No reimbursement shall be allowed for additional costs related to sub-leases. Per diem rates shall be calculated on the basis of actual occupancy.
Occupancy is defined as actual physical resident days.
A provisional per diem rate shall be established for the first quarter of each state fiscal year based upon each facility's operating budget and projected resident population. Provisional per diem rates shall be established for the second, third, and fourth quarters of each state fiscal year based upon actual allowable cost and actual physical resident days for the previous quarter. Allowances may be made for known future costs not incurred in the previous quarter if those costs will be incurred prior to the end of the subsequent quarter. This rate shall be compared to the provisional rate paid for that quarter, and a financial adjustment shall be made to adjust for any over or under payments. All facilities shall be audited at a minimum of once every three years.