DAR File No. 42851

Health, Health Care Financing, Coverage and Reimbursement Policy

Section R414-401-3

Assessment

Notice of Proposed Rule

(Amendment)

DAR File No.: 42851
Filed: 04/25/2018 11:36:59 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this change is to update the annual assessment amounts for nursing care facilities and Intermediate Care Facilities for Persons with Intellectual Disabilities (ICFs/ID) for State Fiscal Year (SFY) 2019.

Summary of the rule or change:

In Subsection R414-401-3(2), every nursing facility is assessed at the uniform rate of $23.04 per patient day, which is an increase from the previous $20.98 per patient day assessment, based upon projected days. In Subsection R414-401-3(2), ICFs/ID are assessed at the uniform rate of $9.71 per patient day, which is an increase from the previous $8.36 per patient day assessment, based upon projected days. These updates are based on estimates of patient days for SFY 2019 and the appropriation amounts.

Statutory or constitutional authorization for this rule:

• Section 26-18-3

Anticipated cost or savings to:

the state budget:

These updates to the assessment rates are anticipated to be budget neutral for state general funds as it updates the collection rate based on projected days in SFY 2019 and the appropriation amount.

local governments:

Inasmuch as swing beds are variable, it is not possible to determine the cost or savings to local hospital and swing bed facilities because there are neither sufficient nor cost effective data to make this type of determination.

small businesses:

Small business nursing facilities will be charged an assessment of $2,251,500 in SFY 2019, and will receive a portion of $5,216,200 in federal matching funds to elevate services, upgrade facilities, and improve overall living conditions for Medicaid patients. In conjunction with a capital improvement incentive, ICFs/ID will be charged a one-time assessment of $291,000 in SFY 2019, and will receive a portion of $1,475,200 in federal funds to improve facility conditions that support an individual's right to privacy and autonomy. Both nursing facilities and ICFs/ID will see ongoing revenue, but there are neither sufficient nor cost effective data to estimate an amount.

persons other than small businesses, businesses, or local governmental entities:

Nursing facilities will be charged an assessment of $2,251,500 in SFY 2019, and will receive a portion of $5,216,200 in federal matching funds to elevate services, upgrade facilities, and improve overall living conditions for Medicaid patients. In conjunction with a capital improvement incentive, ICFs/ID will be charged a one-time assessment of about $291,000 in SFY 2019, and will receive a portion of $1,475,200 in federal funds to improve facility conditions that support an individual's right to privacy and autonomy. Both nursing facilities and ICFs/ID will see ongoing revenue, but there are neither sufficient nor cost effective data to estimate an amount.

Compliance costs for affected persons:

A single nursing facility will be charged an assessment based on a total charge of $2,251,500 in SFY 2019, and will receive a portion of $5,216,200 in federal matching funds to elevate services, upgrade facilities, and improve overall living conditions for Medicaid patients. In conjunction with a capital improvement incentive, a single ICF/ID will be charged a one-time assessment based on a total charge of $291,000 in SFY 2019, and will receive a portion of $1,475,200 in federal funds to improve facility conditions that support an individual's right to privacy and autonomy.

Comments by the department head on the fiscal impact the rule may have on businesses:

Nursing facilities and ICFs/ID will be charged assessments that total about $2,542,500. These charges, however, will be matched by federal funds that total about $6,691,400 to improve the overall living conditions of Medicaid patients in these facilities.

Joseph K. Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Health Care Financing, Coverage and Reimbursement Policy
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at cdevashrayee@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

06/14/2018

This rule may become effective on:

07/01/2018

Authorized by:

Joseph Miner, Executive Director

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs	FY 2018	FY 2019	FY 2020
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$2,542,500	$0
Non-Small Businesses	$0	$2,542,500	$0
Other Person	$0	$2,542,500	$0
Total Fiscal Costs:	$0	$2,542,500	$0
Fiscal Benefits
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$6,691,400	$0
Non-Small Businesses	$0	$6,691,400	$0
Other Persons	$0	$6,691,400	$0
Total Fiscal Benefits:	$0	$6,691,400	$0
Net Fiscal Benefits:	$0	$6,691,400	$0

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described above. Inestimable impacts for Non-Small Businesses are described below.

 

Appendix 2: Regulatory Impact to Non-Small Businesses

88 nursing facilities will incur annual assessment costs up to $2,251,500. These facilities, however, will receive a portion of $5,216,200 in federal matching funds to improve facility services. As part of a capital improvement incentive (CII), 17 Intermediate Care Facilities for Persons with Intellectual Disabilities (ICFs/ID) will see a one-time assessment cost of $291,000 to upgrade facilities and living conditions. This cost, however, will be offset by a portion of $1,475,200 in federal matching funds. Both nursing facilities and ICFs/ID will see ongoing revenue, but there are neither sufficient nor cost effective data to estimate an amount.

 

The Executive Director of the Department of Health, Joseph K. Miner, M.D., has reviewed and approved this fiscal analysis.

 

 

R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

R414-401. Nursing Care Facility Assessment.

R414-401-3. Assessment.

(1) The collection agent for the nursing care facility assessment shall be the Department, which is vested with the administration and enforcement of the assessment.

(2) The uniform rate of assessment for every facility is $[20.98]23.04 per non-Medicare patient day provided by the facility, except that intermediate care facilities for people with intellectual disabilities shall be assessed at the uniform rate of $[8.36]9.71 per patient day. Swing bed facilities shall be assessed the uniform rate for nursing facilities. The Utah State Veteran's Home is exempted from this assessment and this rule.

(3) Each nursing care facility must pay its assessment monthly on or before the last day of the next succeeding month.

(4) The Department shall extend the time for paying the assessment to the next month succeeding the federal approval of a Medicaid State Plan Amendment allowing for the assessment, and consequent reimbursement rate adjustments.

 

KEY: Medicaid, nursing facility

Date of Enactment or Last Substantive Amendment: [July 1, 2017]2018

Notice of Continuation: April 7, 2014

Authorizing, and Implemented or Interpreted Law: 26-1-30; 26-35a; 26-18-3