Increase Payment Rate for Nursing Homes with Special Populations
Biennium
2020-2022
Budget Round
Initial Bill
Half Sheet Number
313 #6c
Description
This amendment adds funding each year and language to change the reimbursement methodology for nursing facilities that provide services to a resident population in which at least 80 percent of the residents have specific chronic and disabling conditions and the facility has at least a 90 percent Medicaid utilization and a case mix index of 1.15 or higher in fiscal year 2021. These conditions tend to occur in a younger population who consequently have a significantly longer stay in a nursing facility than many nursing home residents. Consequently, the costs to serve these individuals is much higher. Currently, only one nursing facility, the Virginia Home, would meet the criteria to qualify for additional funding pursuant to the reimbursement methodology change.