Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 2 › Subtitle 09 - MEDICAL CARE PROGRAMS › Chapter 10.09.10 - Nursing Facility Services › Section 10.09.10.15-1 - New Nursing Facilities, Replacement Facilities, and Change of Ownership for Rates Effective January 1, 2015

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Department shall establish rates for
				  new nursing facilities, replacement facilities, and nursing facilities with a
				  change of ownership as outlined in §§B-D of this
				  regulation.
B. New Nursing
				  Facilities.
(1) Until such time as an
				  appraisal for the new facility is available as set forth in Regulation
				  .10-1B(1)(b) of this chapter, the fair rental value per diem rate shall be
				  based on the lower of the facility's construction costs plus the assessed land
				  value divided by the number of licensed beds, or the maximum appraised value
				  per bed in Regulation .10-1B(1)(g) of this chapter.
(2) A new nursing facility shall be assigned
				  the Statewide average Medicaid CMI until assessment data submitted by the
				  nursing facility is used in a quarterly rate determination.
(3) The nursing facility shall be assigned to
				  the appropriate geographic region, as specified under Regulation .24 of this
				  chapter, for purposes of assigning the Nursing Service rate, the Other Patient
				  Care price, and the Administrative and Routine price.
(4) The geographic region price for Nursing
				  Service costs shall be multiplied by the new nursing facility's Medicaid CMI
				  until there is a nursing facility cost report used in the rebasing
				  process.
(5) The fair rental value
				  per diem rate shall use days as the greater of total estimated resident days or
				  days at full occupancy times an occupancy standard calculated under Regulation
				  .08-1B(4) of this chapter and the maximum bed value identified in Regulation
				  .10-1B(1)(g) of this chapter.
(6)
				  Upon providing the real estate bills to the State which incorporate the new
				  construction at least 15 days before the start of operations or at least 15
				  days before the beginning of any calendar quarter, the real estate tax per diem
				  rate shall be calculated in accordance with Regulation .10-1B(1)(l) of this
				  chapter. This amount shall be used for the period from the time of submission
				  until the next facility cost report is filed. For the period of time the
				  facility is operating under a waiver of occupancy granted in accordance with
				  Regulation .16-1F of this chapter, the real estate tax per diem rate shall be
				  calculated using estimated resident days. At the completion of the waiver
				  period, either the State or the facility may initiate a settlement payment
				  should the estimate vary from the actual by more than 10 percent.
(7) For the first 2 State fiscal rate setting
				  years, or portions thereof, new nursing facilities that are required to pay an
				  assessment in accordance with COMAR
				  10.01.20.02 shall receive a
				  Quality Assessment add-on calculated as follows:
(a) Estimate the assessed days to be reported
				  on the Nursing Facility Quality Assessment Payment Reporting Forms for the
				  quarters covering the upcoming State fiscal rate setting year or portion
				  thereof;
(b) Multiply the estimated
				  assessed days by the assessment rate anticipated for the rate quarters;
				  and
(c) Divide the total estimated
				  assessed amount by the sum of the total estimated patient days. At the
				  completion of either of these first two rate setting periods, either the State
				  or the facility may initiate a settlement payment should the estimates vary
				  from the actual by more than 10 percent.