1 Facility Specific Non Comp Price (Schedule 1) 2 Statewide Direct Price
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1 Nursing Home Statewide Price Summary Sheet Medicaid Rate Medicaid Rate Medicaid Rate for Part B for Part D for Part B&D Medicaid Eligible Eligible Eligible Rate Patients Patients Patients Nursing Home Price Calculation 1 Facility Specific Non Comp Price (Schedule 1) 2 Statewide Direct Price WEF Adjustment (Schedule 2) 4 Facility Case Mix Adjustment (Schedule 4) 5 WEF and Case Mix Adjusted Price Statewide Indirect Price WEF Adjustment (Schedule 2) 8 WEF Adjusted Indirect Price Total Operating Component DEM, BMI, TBI Per Diem Add Ons (Schedule 3) 11 Transition Adjustment 12 Quality Adjustment (Schedule 5) 13 Misc. Per Diem Adjustments 14 Adj Per PHL Section 2808(25)(C) Adjustment to Cap Case Mix 5.0% Total Price Capital Per Diem Total Price + Capital Per Diem Rate Is Approved as of Jun NF 1 of 7
2 Non-Comparable Component Calculation Schedule 1 Non Comparable Component Total Allowable Costs Total Patient Days Non Comparable Per Diem Wage Equalization Factor Adjustment Schedule 2 Direct Wef Calculation Regional Wef Adjustment % of Regional Wef Facility Specific Wef Adjustment % of Facility Specific Wef Final Blended Wef Indirect Wef Calculation Regional Wef Adjustment % of Regional Wef Facility Specific Wef Adjustment % of Facility Specific Wef Final Blended Wef Rate Is Approved as of Jun NF 2 of 7
3 Dementia, TBI, and BMI Addon Calculations Schedule 3 Dementia Add On Total Dementia Patient Count 6 Rate Add On 8.00 Days in Year 365 Add On Total Medicaid Days Per Diem Amount 0.38 Traumatic Brain Injury Add On No Reported Data Bariatric Add On Total BMI Patient Count 28 Rate Add On Days in Year 365 Add On Total Medicaid Days Per Diem Amount 3.77 Current Medicaid Only Case Mix Calculation Schedule 4 Current MDS Case Mix Total Current MDS Case Mix Patients Facility Specific Case Mix % Peer Group/50% Statewide Case Mix Facility Case Mix Adjustment Rate Is Approved as of Jun NF 3 of 7
4 Quality Adjustment Schedule 5 Adjustment to Fund Quality Pool 0.00 Quality Pool Award Total Quality Adjustment 0.00 Rate Is Approved as of Jun NF 4 of 7
5 May :03AM New York State Department of Health Office of Health Insurance Programs Division of Health Care Financing 07/01/2013 Current Facility MDS Summary All Payer RUG III Case Mix Patient Case Mix RUG III Case Mix Patient Case Mix Category Index Count Total Category Index Count Total RUX SSB RUL SSA 1.03 RVX CC RVL CC RHX CB RHL CB RMX CA RML CA RLX IB RUC IB RUB IA RUA IA RVC BB RVB BB RVA BA RHC BA RHB PE RHA PE RMC PD RMB PD RMA PC RLB PC RLA PB SE PB SE PA SE PA SSC BC Case Mix Total Total Patient Count Case Mix Index Rate Is Approved as of Jun NF 5 of 7
6 May :03AM New York State Department of Health Office of Health Insurance Programs Division of Health Care Financing 07/01/2013 Current Facility MDS Summary Medicaid Only RUG III Case Mix Patient Case Mix RUG III Case Mix Patient Case Mix Category Index Count Total Category Index Count Total RUX SSB RUL SSA 1.03 RVX CC RVL CC RHX CB RHL CB RMX CA RML CA RLX IB RUC IB RUB IA RUA IA RVC BB RVB BB RVA BA RHC BA RHB PE RHA PE RMC PD RMB PD RMA PC RLB PC RLA PB SE PB SE PA SE PA SSC BC Case Mix Total Total Patient Count Case Mix Index Rate Is Approved as of Jun NF 6 of 7
7 OFFICE OF HEALTH INSURANCE PROGRAMS Base Costs and Prices Worksheet COST REPORT BASE - Facility Reported - Dec :06AM : Genesee County Nursing Home DCN: V Nursing Home Cost Base NF Freestanding Facility Non-Comparable Cost Per Diem Computation - By Cost Center Cost Amount Adjust- Amount Trend Amount Trace- Final Center Reported ments Allowed Factor Allowed back % Amount Trended Allowed , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,790 Total Allowed Costs 657,437 Patient Days 55,885 Non-Comparable Per Diem prior to Ipafs Cost Center Descriptions Medical Director s Office 31 Laboratory Services 34 Radiology 37 Dental 38 Psychiatric 44 Medical Staff Services 106 Constructed Cost Center 242 Constructed Cost Center Rate Is Approved as of Jun NF 7 of 7
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