Bureau of Coverage and Reimbursement Policy


Mailing information:

Via U.S. Post Office
Utah Department of Health
DHCF, BCRP
Attn: Reimbursement
PO Box 143102
Salt Lake City, UT 84114-3102
Via UPS or FedEx
Utah Department of Health
DHCF, BCRP
Attn: Reimbursement
288 North 1460 West
Salt Lake City, UT 84116-3231

If you are unsure about an issue, please ask questions.


Medicaid Nursing Facility:
 

FINAL Utah Medicaid Nursing Facility Rates - FINAL Rates for Utah Medicaid Nursing Facilities for the period January 1 through March 31, 2017.
(Click here for historical rates)

PREVIEW of Utah Medicaid Nursing Facility Rates - PREVIEW Rates for Utah Medicaid Nursing Facilities for the period January 1 through March 31, 2017.

Add-On Rate History - Listing of all Nursing Home add-on rates since 7/1/2004.

Case Mix Preview Report - Nursing homes may request a preview report of the MDS data used in upcoming quarter's case mix portion of the rate.  This section outlines how to request the report for your facility.


SFY 2017 Nursing Facility QI Incentive Program Information:

To submit applications or forms
Email: QII_DMHF@utah.gov
Fax: 801-237-0788

This program has been approved by CMS. 

NH Introduction Letter

    QI Incentive Program 1
    QI Incentive Program 3
***Please be aware that the application asks that the facility has documented the residents' choice program for all 3 areas***

April 20, 2016 Nursing Home Industry Presentation (Adobe Acrobat file)

ACO and Nursing Facility Responsibilities: Document


Nursing Facility Non-state Government Owned UPL Program:

(Refer to Rule R414-505 for more details)

Download NSGO NF UPL Program Notice of Participation Form

Download IGT Certification Form


ICF/ID:

ICF/ID Rates - for SFY 2017
(Click here for historical rates)

(Click here for ICF/ID Updates from April 20, 2015 conference)
(Click here for Wage Rate Spreadsheet due by 7/27/2015)

SFY 2017 ICF/ID QI Incentive Program Information:

This program has been approved by CMS. 

ICF/ID Introduction Letter

ICF-ID QII (1) Form (Due on or before May 31st)


Bed Assessment Rates:

For questions, contact
LynAnn Williams
Phone: 801-538-9071
Fax: 801-538-6478

Effective Start Date Nursing and Swing ICF/ID
7/1/2016 $18.74 $8.45
7/1/2015 $18.32 $8.46
7/1/2014 $15.40 $8.48
7/1/2013 $14.57 $6.50
7/1/2012 $14.50 $6.80
7/1/2011 $12.75 $6.94
7/1/2010 $12.25 $6.53
7/1/2009 $10.20 $6.53
7/1/2008 $8.96 $5.52
7/1/2007 $8.96 $5.52
7/2/2004 $6.18 $5.52

Monthly Patient Day Report (pdf) or Patient Day Report (Word doc)

ICF/ID Monthly Patient Day Report (pdf) or Patient Day Report (Word doc)

Link to State Rule


Miscellaneous:


Additional Resources:


Utah Medicaid RUG Weights

Record Selection and Case Mix Calculation (July 2007)

Fair Rental Value (FRV) form for determining the daily rate for new Nursing Facilities - FRV Calculation - to be returned to Steven Jones (stjones@utah.gov) prior to daily calculation

Fair Rental Value Sample Calculator (Excel)

Utah State Rule R414-504 relating to nursing facility reimbursement

Utah State Plan Attachment 4.19-D relating to nursing facility reimbursement

Transfer of nursing home beds


Reporting:


Facility Cost Profile Reports

FRV Data Reports