AGING AND DISABILITY SERVICES ADMINISTRATION

2005 NH "Dear Administrator " Letters

March 31, 2005

ADSA: NH # 2005-007
SUBJECT: APRIL 1, 2005 ADJUSTED MEDICAID PAYMENT RATE

Dear Nursing Facility/Home Administrator:

The Rate Computation Worksheet for your facility’s April 1, 2005 adjusted Medicaid payment rate is enclosed.

Except for the different quarter RUG data, the department calculated your facility’s April 1, 2005 adjusted rate using the same data used to calculate your facility’s Medicaid payment rate for July 1, 2004. The department calculated your facility’s April 1, 2005 adjusted rate using your facility’s Medicaid Average Case Mix Index (with defaults) from the 4 th Quarter of 2004 (October through December 2004) final RUG report. The department calculated your facility’s January 1, 2005 rate using your facility’s Medicaid Average Case Mix Index (with defaults) from the 3rd Quarter of 2004 (July through September 2004) final RUG report.

If a timely appeal of your July 1, 2004 rate is pending, when it is resolved, any changes made to adjustments because of this appeal will be brought forward to the facility’s April 1, 2005 adjusted rate.

Enclosed you will also find a 4 th Quarter 2004 final RUG report.

Under WAC 388-96-901 (2) (f), the quarterly updates of a facility’s resident case mix are not subject to review under WAC 388-96-904.

Please call your Medicaid rate analyst or Ken Callaghan, Nursing Home Rates Section Manager, at (360) 725-2469 if you have any questions about this letter.

Sincerely,

Tom Kearns, Chief
Office of Rates Management

pah

Enclosures