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Public Notice of Final Actions for Long Term Care Facility Services (Excluding State Owned Nursing Facilities)

The South Carolina Department of Health and Human Services (SCDHHS), pursuant to the requirements of Section 1902(a)(13)(A) of the Social Security Act, gives notice of the following proposed actions regarding its methods and standards for setting payment rates for long term care facility services (excluding state owned nursing facilities) under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for services provided on or after October 1, 2017, SCDHHS proposes to amend the South Carolina Title XIX reimbursement methodology for long term care by:

  1. Providing payments to nursing facilities based on the most recent cost report data available (i.e., FYE September 30, 2016)
  2. Updating the cost center standards based upon the FYE September 30, 2016 Medicaid cost reports
  3. Updating the owner/relative compensation guidelines based upon the federal fiscal year ending 2016 payroll surveys
  4. Applying a 2.90% inflation factor in the calculation of the October 1, 2017 payment rates
  5. Applying an updated deemed asset value ($55,236) and market rate of return factor (2.92%) for October 1, 2017 Medicaid rate setting purposes
  6. Increasing the Medicaid reimbursement rate for the one South Carolina vent unit facility from $450.00 per Medicaid patient day to $530.00 per Medicaid patient day; and
  7. Reimbursing impacted nursing facilities for Medicaid's share of allowable Hurricane Matthew related evacuation costs (net of insurance proceeds) due to the mandatory evacuation issued by the Governor.

SCDHHS is proposing the above actions in order to determine Medicaid reimbursement rates based upon the most recent cost report data available, updated owner/relative compensation guidelines, and to provide payment to impacted nursing facilities for Medicaid's portion of costs related to the Governor's mandatory evacuation issued as a result of Hurricane Matthew.

As a result of the proposed actions relating to the Medicaid reimbursement methodology changes for nursing facilities effective for services provided on or after October 1, 2017, the weighted average rate is projected to be $176.29. The weighted average September 30, 2017 rate was $171.37. This represents a weighted average per diem increase of $4.92 per Medicaid patient day, or a 2.87% increase.

SCDHHS projects that based upon the proposed actions, annual aggregate expenditures will increase by approximately $15,600,000 total dollars including Medicaid days paid while the recipient is under the Hospice benefit.

Copies of this notice are available at each County Department of Health and Human Services Office and at www.scdhhs.gov for public review. Additional information concerning the proposed action is available upon request at the address cited below.

Written comments may be sent to the Division of Long Term Care Reimbursements, South Carolina Department of Health and Human Services, Post Office Box 8206, Columbia, South Carolina 29202-8206. Comments may also be submitted to comments@scdhhs.gov. Written and e-mailed comments must be received by close of business September 12, 2017.

Any written comments submitted may be reviewed by the public at the SCDHHS, Division of Long Term Care Reimbursements, 12th floor, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9:00 A.M. and 5:00 P.M.

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