Section 204.10 - Resident Care Cost Quotient(1) Beginning July 1, 2022, residential care facilities must have a Resident Care Cost Quotient (RCC-Q) that meets or exceeds a threshold of 80%. For the rate year beginning in SFY 2024, a residential care facility's rate may be subject to a downward adjustment if the facility fails to be at or above the specified RCC-Q threshold in the previous state fiscal year.(2) The RCC-Q will be calculated by dividing certain resident care expenses by the facility's total revenue, excluding the revenue for non-residential care facility lines of business, and excluding endowment income. EOHHS may further identify or clarify these certain resident care expenses by administrative bulletin or other written issuance. A multiplier may be applied to certain resident care expenses related to one or more resident care workforce position types. EOHHS may establish the workforce position types eligible for any multiplier, details related to application of such multiplier, and the magnitude of such multiplier in calculating the RCC-Q, by administrative bulletin or other written issuance.(3) All resident care facilities, including facilities described in 101 CMR 204.10(5), will be required to submit an interim compliance report by March 1st of each year and a final compliance report by September 1st of each year. The interim report will be used to inform facilities if they are on track to meet the RCC-Q threshold in the reporting period. The final compliance report will be used for determining whether the facility met that threshold and whether a downward adjustment will be applied to the facility's rate in the following rate year.(4) The downward adjustment to the rate will be applied in the following rate year to facilities that failed to meet the RCC-Q threshold or failed to submit the final report by the final compliance report due date. Such downward adjustment will be applied as follows.(a) For every 1% below the 80% RCC-Q threshold, a 0.5% downward adjustment will be applied to the facility's rate.(b) The maximum downward adjustment calculated in accordance with 101 CMR 204.10(4)(a) may be no more than 5% of the facility's rate. EOHHS may apply the maximum downward adjustment of 5% in the following rate year for facilities that fail to submit the final report by the due date established in 101 CMR 204.10(3).(5) Residential care facilities that have fewer than 1,700 SSI/SSP and EAEDC days (also known as DTA days), based on the most recent cost report data available to CHIA, for a particular state fiscal year, starting the state fiscal year of July 1, 2022, through June 30, 2023, except for the facilities that failed to submit the final compliance report by September 1st in accordance with 101 CMR 204.10(3) immediately following the end of the particular state fiscal year, will be exempt from the downward adjustment established at 101 CMR 204.10(4). For purposes of 101 CMR 204.10(5), the RCC-Q minimum paid DTA days will be established by EOHHS by administrative bulletin or other written issuance.(6) EOHHS may issue an administrative bulletin or other written issuance to clarify provisions of 101 CMR 204.10, and as otherwise provided at 101 CMR 204.10.Adopted by Mass Register Issue 1463, eff. 2/4/2022 (EMERGENCY).Amended by Mass Register Issue 1468, eff. 4/29/2022.Amended by Mass Register Issue 1469, eff. 4/29/2022.Amended by Mass Register Issue 1474, eff. 7/1/2022 (EMERGENCY).Amended by Mass Register Issue 1477, eff. 9/2/2022.Amended by Mass Register Issue 1483, eff. 11/10/2022 (EMERGENCY).Amended by Mass Register Issue 1489, eff. 11/10/2022 (EMERGENCY).Amended by Mass Register Issue 1495, eff. 11/10/2022 (EMERGENCY).Amended by Mass Register Issue 1500, eff. 7/7/2023 (EMERGENCY).Amended by Mass Register Issue 1506, eff. 7/7/2023 (COMPLIANCE).Amended by Mass Register Issue 1512, eff. 1/1/2024 (EMERGENCY).Amended by Mass Register Issue 1518, eff. 1/1/2024 (EMERGENCY).Amended by Mass Register Issue 1521, eff. 5/10/2024.