55 Pa. Code § 1181.217 - Establishing ceilings for allowable net operating costs

(a) The Department will establish annual ceilings on allowable net operating costs for each level of care.

(b) For ceiling setting purposes, the following apply:

(1) Certain facilities will be grouped together as follows:

(i) Hospital-based skilled nursing and intermediate care facilities and special rehabilitation facilities separately on a Statewide basis.

(ii) General skilled nursing and intermediate care facilities according to Metropolitan Statistical Areas (MSA) groups. For general skilled nursing and intermediate care facilities the MSA classifications will be grouped, based along geographic and economic lines, into levels as announced by the Federal Office of Management and Budget. For county facilities, Level A will be combined with Level B and Level C will be combined with the non-MSA level. The resulting two levels will be the county nursing facility groups for ceiling setting purposes.

(2) The MSA groupings used by the Department will reflect the latest MSA groupings announced no later than 90 days prior to the implementation date of the new ceilings by the Federal Office of Management and Budget. The MSA groupings will be published by notice in the Pennsylvania Bulletin.

(c) The cost data base for each group ceiling is the allowable net operating costs of each facility within each group. The cost information will be taken from each facility's most recent annual cost report. The Department will use only those year-end cost reports that cover a period of at least 180 days, are acceptable and are received no later than 90 days prior to the implementation date of the new ceilings. Cost reports that meet the requirements of § 1181.66(a)(1) (relating to setting ceilings on allowable net operating costs) are acceptable.

(d) The Department will establish ceilings as described in § 1181.66(a)-(c).

Notes

55 Pa. Code § 1181.217

The provisions of this § 1181.217 adopted August 5, 1983, effective 7/1/1983, 13 Pa.B. 2402; amended September 6, 1985, effective 9/7/1985, except groups and ceilings shall be effective and apply at audit to costs of services rendered from July 1, 1984 through December 31, 1984, 15 Pa.B. 3181; amended March 10, 1989, effective immediately and applies retroactively to January 1, 1989, 19 Pa.B. 1005.

The provisions of this § 1181.217 amended under sections 201 and 443.1(2) of the Public Welfare Code (62 P. S. §§ 201 and 443.1(2)).