Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.03.10 - MEDICAID ENHANCED PLAN BENEFITS › SUB AREA: LONG-TERM CARE › Section 16.03.10.275 - NURSING FACILITY: PROPERTY RENTAL RATE REIMBURSEMENT

Current through August 31, 2023
Free standing nursing facilities other than hospital based
				  nursing facilities will be paid a property rental rate. Property taxes and
				  property insurance will be reimbursed as costs exempt from limitations. The
				  property rental rate includes compensation for major movable equipment but not
				  for minor movable equipment. The property rental rate is paid in lieu of
				  payment for amortization, depreciation, and interest for financing the cost of
				  land and depreciable assets. Prior to final audit for free-standing nursing
				  facilities, an interim rate for property reimbursement will be set to
				  approximate the property rental rate as determined by Sections
				  56-108 and
				  56-109, Idaho Code.
				  (3-17-22)
01.
Property Rental
				Rate
. The property rental rate is based upon current construction costs,
				the age of the facility, the type of facility, and major expenditures made to
				improve the facility, or a rate based upon property costs as of January 1,
				1985. The amount paid for each Medicaid day of care will be phased in according
				to Section 275.01 of these rules, and,
				beginning April 1, 1985, will be: (3-17-22)
R = "Property Base" x 40 - "Age" / 40 x "change in building
				  costs" where: (3-17-22)
a. "R" = the
				property rental rate. (3-17-22)
b.
				"Property Base" = thirteen dollars and nineteen cents ($13.19) beginning
				October 1, 1996 for all freestanding nursing facilities. (3-17-22)
c. "Change in building costs" = 1.0 from
				October 1, 1996, through December 31, 1996. Beginning January 1, 1997, "change
				in building costs" will be adjusted each calendar year to reflect the reported
				annual change in the building cost index for a class D building in the western
				region, as published by the Marshall Swift Valuation Service or the consumer
				price index for renter's costs whichever is greater. For freestanding nursing
				facilities, the index available in September of the prior year will be used.
				(3-17-22)
d. "Age" of facility -
				The effective age of the facility in years will be set by subtracting the year
				in which the facility, or portion thereof, was constructed from the year in
				which the rate is to be applied. No facility or portion thereof will be
				assigned an age of more than thirty (30) years, however: (3-17-22)
i. If adequate information is not submitted
				by the facility to document that the facility, or portion thereof, is newer
				than thirty (30) years, the age will be set at thirty (30) years. Adequate
				documentation will include, but not be limited to, such documents as copies of
				building permits, tax assessors' records, receipts, invoices, building
				contract, and original notes of indebtedness. An age will be determined for
				each building. A weighted average using the age and square footage of the
				buildings will become the effective age of the facility. The age of each
				building will be based upon the date when construction on that building was
				completed. This age will be adjusted to reflect major building expansion or
				remodeling prior to April 1, 1985, if that expenditure was large enough to
				reduce the age of the facility by two (2) or more years according to the
				following formula: (3-17-22)
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Where:
r = Reduction in the age of the facility in
								years.
A = Age of the building at the time when
								construction was completed.
E = Actual expenses for the construction provided
								that the total costs must have been incurred within twenty-four (24) months of
								the completion of the construction.
S = The number of square feet in the building at
								the end of construction.
C = The cost of construction for the buildings in
								the year when construction was completed according to the schedule in
								Subsection 275.01.d.ii.
If the result of this calculation, "r" is equal to or greater
				  than 2.0, the age of the building in years will be reduced by this number,
				  rounded to the nearest whole number for rate setting purposes. In no case will
				  the age be less than zero (0). (3-17-22)
ii. Historical nursing home construction cost
				per square foot for purposes of evaluating facility age.
Age
Year
Cost
Age
Year
Cost
Age
Year
Cost
1
2004
82.41
2
2003
80.80
3
2002
79.06
4
2001
78.43
5
2000
74.34
6
1999
71.55
7
1998
71.34
8
1997
68.20
9
1996
67.59
10
1995
66.19
11
1994
64.14
12
1993
60.56
13
1992
59.03
14
1991
56.13
15
1990
54.61
16
1989
53.17
17
1988
52.03
18
1987
51.66
19
1986
51.56
20
1985
50.55
(3-17-22)
iii. For rates paid after June 30, 1989, the
				effective age of a facility will be further adjusted when the cost of major
				repairs, replacement, remodeling, or renovation of a building initiated after
				April 1, 1985, results in the change in age by at least one (1) year when
				applied to the formula in Subsection
				275.01.d.i. of these rules.
				However, such change will not decrease the effective age of a facility beyond
				the point where the increase in the property rental rate is greater than
				three-fourths (3/4) of the difference between the property rental rate "r" for
				a new facility at the time of the proposed rate revision and the property
				rental rate for which the facility was eligible immediately before the
				adjustment. The cost used for "C" will be adjusted according to costs published
				by Marshall Swift Valuation Service to reflect current construction costs for
				average Class D convalescent hospitals. It is the provider's responsibility to
				notify the Department and document costs. The Department will adjust the age
				after documentation of costs. (3-17-22)
iv. In the event that new requirements are
				imposed by state or federal agencies, the Department will reimburse the
				expenditures directly related to these requirements as an increase in the
				property rental rate if the expense is in excess of one hundred dollars ($100)
				per bed. If the cost related to the requirement is less than one hundred
				dollars ($100) per bed, the Department will, within twelve (12) months of
				verification of expenditure, reimburse the Medicaid share of the entire cost of
				such new requirements, as a one (1) time payment to the facility.
				(3-17-22)
v. At no time will the
				property rental rate paid to a facility be less than the greater of the rate
				allowable to that facility on December 31, 1988, the rate allowable immediately
				following the first opening of a new facility after December 31, 1988, or the
				rate allowable immediately following the last, if any, age revision after
				December 31, 1988. However, subsequent to the application of this provision,
				before any property rental rate increase may be made for current or successor
				operators, the final settlement amount of any increase in the property rental
				rate will first be offset by an amount equal to the impact on final settlement
				of any rate decrease that would have occurred if the provisions of Subsections
				275.01.d.iii. and
				275.01.d.iv. of these rules had not been applied. This is intended to allow the
				postponement of the financial burden to providers of property rental rate
				decreases and to allow an equal offset of the financial burden to the state of
				subsequent property rate increases for a current or successor provider.
				(3-17-22)
vi. Effective July 1,
				1991, for freestanding nursing facilities, "age of facility" will be a revised
				age that is the lesser of the age established under other provisions of this
				Section or the age that most closely yields the rate allowable to existing
				facilities as of June 30, 1991, under Subsection
				275.01 of these rules. This
				revised age will not increase over time.
				(3-17-22)