D.C. Mun. Regs. tit. 29, r. 29-6518

Current through Register Vol. 71, No. 49, December 6, 2024
Rule 29-6518 - REIMBURSEMENT FOR NEW PROVIDERS
6518.1

Each new provider shall be assigned to the appropriate peer group as set forth in § 6502.1.

6518.2

The per diem rate for each new provider shall be the base year day-weighted average case mix neutral peer group price for nursing and resident care and the peer group price for routine and support services.

6518.3

The capital per diem for each new provider shall be the greater of the base year day-weighted average per diem of facilities in the assigned peer group, or the median per diem for the peer group.

6518.4

Each new provider may receive an add-on payment for each resident that qualifies and receives ventilator care pursuant to §§ 6508 - 6510 or for residents qualifying for reimbursement as behaviorally complex pursuant to §§ 6511- 6512 or bariatric care, pursuant to §§ 6513 - 6514.

6518.5

DHCF shall notify, in writing, each new nursing facility of its payment rate calculated in accordance with this section. The rate letter to a new provider shall include the per diem payment rate calculated in accordance with this section.

D.C. Mun. Regs. tit. 29, r. 29-6518

Final Rulemaking published at 53 DCR 1370 (February 24, 2006); amended by Final Rulemaking published at 66 DCR 13664 (10/18/2019)