Or. Admin. R. 411-070-0417 - Treatment of Complex Medical Add-Ons

(1) The complex medical add-on reflects the additional costs of providing skilled nursing services for certain residents due to their needs.

(2) The complex medical add-on is added to the basic rate.

(3) When calculating per resident day care compensation cost, the treatment of the complex medical add-on is as follows:

(a) The allowable care compensation costs for both the basic rate and the complex medical add-on are divided by total basic rate resident days.

(b) Revenue from the complex medical add-on received for eligible individuals is divided by the number of Medicaid basic rate resident days.

(c) The per resident day amounts computed in section (3)(a) of this rule are reduced by the per Medicaid resident day amounts computed in section (3)(b) of this rule. The result is defined as care compensation per resident day and shall be used in determining the prospective base rate.

Notes

Or. Admin. R. 411-070-0417

SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93; SSD 1-1997, f. 6-30-97, cert. ef. 7-1-97; SPD 15-2009, f. 11-30-09, cert. ef. 12-1-09

Stat. Auth.: ORS 410.070

Stats. Implemented: ORS 410.070