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Reimbursement Unit

 

Medicaid Rate Resources

For questions, contact
Steven Jones
Phone: 801-538-6862
Fax: 801-323-1595

For questions about Eligibility or individual Patient Care, click here.


Mailing information:

Via U.S. Post Office
Utah Department of Health
DMHF, BCRP
Attn: Reimbursement
PO Box 143102
Salt Lake City, UT 84114-3102
Via UPS or FedEx
Utah Department of Health
DMHF, 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:
 

Utah Medicaid Nursing Facility Rates - Rates for Utah Medicaid Nursing Facilities for the period July 1 through September 30, 2015.
(Click here for historical rates)

PREVIEW of Utah Medicaid Nursing Facility Rates - PREVIEW Rates for Utah Medicaid Nursing Facilities for the period October 1 through December 31, 2015.

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 2015 Nursing Facility QI Incentive Program Information

This program has been approved by CMS.  The Introduction letter below explains the program.

NH Introduction Letter


QI Incentive Program 1

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

QI Incentive Program 3

QII (3) Form (Due on or before May 31st)

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

-Awake Time

-Meal Time

-Bath Time

QII (3) Choice Example

April 20, 2015 Nursing Home Industry Presentation (Adobe Acrobat file)

ACO and Nursing Facility Responsibilities Document

April 20, 2015 PRISM Testing Request Slides Presentation (PowerPoint file)


ICF/ID:

ICF/ID Rates - for SFY 2016
(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 2016 ICF/ID QI Incentive Program Information

This program has been approved by CMS.  The Introduction letter below explains the program.

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
7/2/2004 $6.18 $5.52
7/1/2007 $8.96 $5.52
7/1/2008 $8.96 $5.52
7/1/2009 $10.20 $6.53
7/1/2010 $12.25 $6.53
7/1/2011 $12.75 $6.94
7/1/2012 $14.50 $6.80
7/1/2013 $14.57 $6.50
7/1/2014 $15.40 $8.48
7/1/2015 $18.32 $8.46

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:

Swing Bed Rates

For the period 1/1/2006 to 12/31/2006

For the period 1/1/2007 to 12/31/2007

For the period 1/1/2008 to 12/31/2008

For the period 1/1/2009 to 12/31/2009

For the period 1/1/2010 to 12/31/2010

For the period 1/1/2011 to 12/31/2011

For the period 1/1/2012 to 12/31/2012

For the period 1/1/2013 to 12/31/2013

For the period 1/1/2014 to 12/31/2014

For the period 1/1/2015 to 12/31/2015


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


Reporting


Facility Cost Profile Reports

FRV Data Reports

(Click here for Wage Rate Spreadsheet due by 7/27/2015)

  

Last edited April 20, 2015