Nursing Facility Assessment

• Assessment Basis for Fiscal Year 2021-2022

The following nursing facilities will continue to be exempt from the Assessment Program under the methodology for FY 2020-2021:

1. State-owned and operated nursing facilities.
2. Veteran's Administration nursing facilities.
3. Nursing facilities that provide nursing facility services free of charge to all residents.
4. Newly licensed nursing facilities that have not been licensed and operated by the current or previous owner will be exempt until the nursing facility's days are included in the data used as the basis of the assessment. A nursing facility that changes ownership is not considered a newly licensed nursing facility for assessment purposes.

The Department will continue to assess nonexempt nursing facilities at two rates. Under the methodology for FY 2020-2021, an assessment rate of $4.61 which represents a decrease of $2.69 from last year's rate will apply to the following five categories of nursing facilities:

• County nursing facilities.
• Nursing facilities that have 44 or fewer licensed beds.
• Certain continuing care retirement community (CCRC) nursing facilities (see 40 Pa.B. 7297 (December 18, 2010)).
• Nursing facilities with an MA occupancy rate of at least 94% based on Calendar Year (CY) 2018 resident days as of November 19, 2019. For the purpose of qualifying for the lower assessment rate, a nursing facility's MA occupancy rate will be calculated as follows: MA Occupancy Rate = Sum of Total PA MA Days from the CY 2018 resident days data ÷ Sum of Total Resident Days from the CY 2018 resident days data, rounded to two decimals.
• Nursing facilities with at least 125,000 MA days and with an overall occupancy rate of 90% or higher based on the CY 2018 resident days as of November 19, 2019. For the purpose of qualifying for the lower assessment rate, a nursing facility's overall occupancy rate will be calculated as follows: Overall Occupancy Rate = Sum of Total Resident Days from CY 2018 resident days as of November 19, 2019 ÷ (number of licensed beds as of November 18, 2019 × 365), rounded to two decimals.

For all other nonexempt facilities, including nursing facilities that began participation in a CCRC on or after July 1, 2010 an assessment rate of $28.70 will apply which is a decrease of $2.69 from last year's rate.

The Department estimates that the annual aggregate assessment fees for nonexempt nursing facilities will total $425.337 million. The Department will use the State revenue derived from the assessment fees and any associated FFP to support payments to qualified MA nursing facility providers in accordance with applicable laws and regulations.

The following nursing facilities will continue to be exempt from the Assessment Program in FY 2019-2020:

1. State-owned and operated nursing facilities.
2. Veteran's Administration nursing facilities.
3. Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter in which an assessment is collected.
4. Nursing facilities that provide nursing facility services free of charge to all residents.

The department will continue to assess nonexempt nursing facilities at two rates. One rate will apply to five categories of nursing facilities: 

• County nursing facilities
  
• Nursing facilities that have 44 or fewer licensed beds
  
• Qualified nursing facilities affiliated with continuing care retirement communities (CCRC) — (see 40 Pa.B. 7297; Dec. 18, 2010)
  
• Nursing facilities with an MA occupancy rate of at least 94 percent based on the four consecutive assessment quarters beginning April 1, 2017, and ending March 31, 2018, for each nursing facility as of Nov. 13, 2018
  
• Nursing facilities with an overall occupancy rate of 90 percent or higher and at least 125,000 MA days based on the calendar year 207 resident days.

The other rate will apply to all other nonexempt facilities, including nursing facilities that began participation in a CCRC on or after July 1, 2010. Using the applicable rate, the department will calculate an annual assessment amount for each nonexempt facility by multiplying its assessment rate by the facility's historical non-Medicare resident day for the four consecutive assessment quarters beginning April 1, 2017, and ending March 31, 2018. The department will collect the annual assessment amount in four equal quarterly installments.

The department will maintain the same rate structure for FY 2019-2020 as in FY 2018-2019, but the assessment rates represent a uniform decrease of 10 cents from the previous year's rates. For FY 2019-2020, the assessment rates for nonexempt nursing facilities will be as follows:

1. For county nursing facilities, facilities that have 44 or fewer licensed beds, for qualified CCRC nursing facilities, and nursing facilities with an MA occupancy rate of at least 94 percent based on the four consecutive assessment quarters beginning April 1, 2017, and ending March 31, 2018, for each nursing facility as of Nov. 13, 2018, the assessment rate will be $7.30 per historical non-Medicare resident day.
2. For all other nonexempt nursing facilities, the assessment rate will be $31.39 per historical non-Medicare resident day.

The following nursing facilities will continue to be exempt from the Assessment Program in FY 2018-2019:

1. State-owned and operated nursing facilities.
2. Veteran's Administration nursing facilities.
3. Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter in which an assessment is collected.
4. Nursing facilities that provide nursing facility services free of charge to all residents.

The department will continue to assess nonexempt nursing facilities at two rates. One rate will apply to four categories of nursing facilities:

• County nursing facilities
• Nursing facilities that have 44 or fewer licensed beds
• Qualified nursing facilities affiliated with continuing care retirement communities (CCRC) — (see 40 Pa.B. 7297; Dec. 18, 2010)
• Nursing facilities with an MA occupancy rate of at least 94 percent based on the four consecutive assessment quarters beginning April 1, 2016, and ending March 31, 2017, for each nursing facility as of Nov. 13, 2017.

The other rate will apply to all other nonexempt facilities, including nursing facilities that began participation in a CCRC on or after July 1, 2010. Using the applicable rate, the department will calculate an annual assessment amount for each nonexempt facility by multiplying its assessment rate by the facility's historical non-Medicare resident day for the four consecutive assessment quarters beginning April 1, 2016, and ending March 31, 2017. The department will collect the annual assessment amount in four equal quarterly installments.

The department will maintain the same rate structure for FY 2018-2019 as in FY 2017-2018, but the assessment rates represent a uniform decrease of 61 cents from the previous year's rates. For FY 2018-2019, the assessment rates for nonexempt nursing facilities will be as follows:

1. For county nursing facilities, for nursing facilities that have 44 or fewer licensed beds, for qualified CCRC nursing facilities, and nursing facilities with an MA occupancy rate of at least 94 percent based on the four consecutive assessment quarters beginning April 1, 2016, and ending March 31, 2017, for each nursing facility as of Nov. 13, 2017, the assessment rate will be $7.40 per historical non-Medicare resident day.
2. For all other nonexempt nursing facilities, the assessment rate will be $31.49 per historical non-Medicare resident day.

The following nursing facilities will continue to be exempt from the Assessment Program in FY 2017-2018:

1. State-owned and operated nursing facilities
2. Veteran's Administration nursing facilities
3. Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter in which an assessment is collected
4. Nursing facilities that provide nursing facility services free of charge to all residents.

The department will continue to assess nonexempt nursing facilities at two rates. One rate will apply to four categories of nursing facilities:

• County nursing facilities
• Nursing facilities that have 44 or fewer licensed beds
• Qualified nursing facilities affiliated with Continuing Care Retirement Communities (CCRC) — (see 40 Pa.B. 7297; Dec. 18, 2010)
  
• Nursing facilities with an MA occupancy rate of at least 94 percent based on the four consecutive assessment quarters beginning April 1, 2015, and ending March 31, 2016, for each nursing facility as of April 22, 2016.

The other rate will apply to all other nonexempt facilities, including nursing facilities that began participation in a CCRC on or after July 1, 2010. Using the applicable rate, the department will calculate an annual assessment amount for each nonexempt facility by multiplying its assessment rate by the facility's historical non-Medicare resident day for the four consecutive assessment quarters beginning April 1, 2015, and ending March 31, 2016, and collect the annual assessment amount in four equal quarterly installments.

The department will maintain the same rate structure for FY 2017-2018 as in FY 2016-2017. For FY 2017-2018, the assessment rates for nonexempt nursing facilities will be as follows:

1. For county nursing facilities, for nursing facilities that have 44 or fewer licensed beds, for qualified CCRC nursing facilities, and nursing facilities with an MA occupancy rate of at least 94 percent based on the four consecutive assessment quarters beginning April 1, 2015, and ending March 31, 2016, for each nursing facility as of April 22, 2016, the assessment rate will be $8.01 per historical non-Medicare resident day.
2. For all other nonexempt nursing facilities, the assessment rate will be $32.10 per historical non-Medicare resident day.
   

The following nursing facilities will continue to be exempt from the Assessment Program in FY 2016-2017:

1. State-owned and operated nursing facilities.
2. Veteran's Administration nursing facilities.
3. Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter in which an assessment is collected.
4. Nursing facilities that provide nursing facility services free of charge to all residents.

The department will assess nonexempt nursing facilities at two rates. One rate will apply to four categories of nursing facilities:

• County nursing facilities
• Nursing facilities that have 44 or fewer licensed beds
• Qualified nursing facilities affiliated with Continuing Care Retirement Communities (CCRC) — (see 40 Pa.B. 7297; Dec. 18, 2010)
• Nursing facilities with an MA occupancy rate of at least 94 percent based on the four consecutive assessment quarters beginning April 1, 2015, and ending March 31, 2016, for each nursing facility as of April 22, 2016.

The other rate will apply to all other nonexempt facilities, including nursing facilities that began participation in a CCRC on or after July 1, 2010. Using the applicable rate, the department will calculate an annual assessment amount for each nonexempt facility by multiplying its assessment rate by the facility's historical non-Medicare resident day for the four consecutive assessment quarters beginning April 1, 2015, and ending March 31, 2016, and collect the annual assessment amount in four equal quarterly installments.

Although the department will maintain the same basic rate structure for FY 2016-2017, the department is increasing the assessment rate for nonexempt nursing facilities in the higher rate tier from the rates in FY 2016-2017. For FY 2016-2017, the assessment rates for nonexempt nursing facilities will be as follows:

• For county nursing facilities, for nursing facilities that have 44 or fewer licensed beds, for qualified CCRC nursing facilities and nursing facilities with an MA occupancy rate of at least 94 percent based on the four consecutive assessment quarters beginning April 1, 2015, and ending March 31, 2016, for each nursing facility as of April 22, 2016, the assessment rate will be $8.01 per historical non-Medicare resident day.
• For all other nonexempt nursing facilities, the assessment rate will be $32.10 per historical non-Medicare resident day. Assessment payments are due the last day of the assessment quarter or 30 days after publication of this second notice, whichever is later.

Nursing facilities will be exempt from payment of the assessment if they fall into any of the following categories:

1. Government owned and operated nursing facilities
2. Veterans Administration nursing facilities
3. Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter for which an assessment is collected.
4. Nursing facilities that provide nursing facility services free of charge to all residents.

As in the first five years of the Assessment Program, nonexempt nursing facilities will continue to be assessed on a quarterly basis during FY 2015-2016 based on the number of licensed beds in the facility, the nursing facility's CCRC or county status, and the number of non-Medicare resident days during each calendar quarter immediately preceding the assessment quarter. During FY 2015-2016, the assessment rates for nonexempt facilities will be as follows:

• The assessment rate for the county nursing facilities, nursing facilities that either have 44 or fewer licensed beds, grandfathered CCRC nursing facilities that have certified continued participation within the CCRC and any nursing facilities with an MA occupancy rate of at least 94 percent based on the latest four assessment quarters for each nursing facility as of Nov. 5, 2014, will be $8.01 per non-Medicare resident day.
• The assessment rate for all other nonexempt nursing facilities will be $30.06 per non-Medicare resident day.
  

Nursing facilities will be exempt from payment of the assessment if they fall into any of the following categories:

1. Government-owned and operated nursing facilities
2. Veterans Administration nursing facilities
3. Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter for which an assessment is collected.
4. Nursing facilities that provide nursing facility services free of charge to all residents.

As in the first five years of the Assessment Program, nonexempt nursing facilities will continue to be assessed on a quarterly basis during FY 2014-2015 based on the number of licensed beds in the facility, the nursing facility's CCRC or county status, and the number of non-Medicare resident days during each calendar quarter immediately preceding the assessment quarter. During FY 2014-2015, the assessment rates for nonexempt facilities will be as follows:

• The assessment rate for the county nursing facilities, nursing facilities that either have 44 or fewer licensed beds and for grandfathered CCRC nursing facilities that have certified continued participation within the CCRC, will be $8.01 per non-Medicare resident day.
• The assessment rate for all other nonexempt nursing facilities will be $29.46 per non-Medicare resident day.

Nursing facilities will be exempt from payment of the assessment if they fall into any of the following categories:

1. Government-owned and operated nursing facilities
2. Veterans Administration nursing facilities
3. Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter for which an assessment is collected.
4. Nursing facilities that provide nursing facility services free of charge to all residents.

As in the first five years of the Assessment Program, nonexempt nursing facilities will continue to be assessed on a quarterly basis during FY 2013-2014 based on the number of licensed beds in the facility, the nursing facility's CCRC or, county status, and the number of non-Medicare resident days during each calendar quarter immediately preceding the assessment quarter. During FY 2013-2014, the assessment rates for nonexempt facilities will be as follows:

• The assessment rate for the county nursing facilities, nursing facilities that either have 50 or fewer licensed beds and for grandfathered CCRC nursing facilities that have certified continued participation within the CCRC, will be $8.32 per non-Medicare resident day.
• The assessment rate for all other nonexempt nursing facilities will be $29.77 per non-Medicare resident day.
  

Nursing facilities will be exempt from payment of the assessment if they fall into any of the following categories:

1. Government-owned and operated nursing facilities
2. Veterans Administration nursing facilities
3. Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter for which an assessment is collected.
4. Nursing facilities that provide nursing facility services free of charge to all residents.

As in the first five years of the Assessment Program, nonexempt nursing facilities will continue to be assessed on a quarterly basis during FY 2012-2013 based on the number of licensed beds in the facility, the nursing facility's CCRC or county status, and the number of non-Medicare resident days during each calendar quarter immediately preceding the assessment quarter. During FY 2012-2013, the assessment rates for nonexempt facilities will be as follows:

• The assessment rate for the county nursing facilities, nursing facilities that either have 50 or fewer licensed beds and for grandfathered CCRC nursing facilities that have certified continued participation within the CCRC, will be $8.09 per non-Medicare resident day.
• The assessment rate for all other nonexempt nursing facilities will be $29.54 per non-Medicare resident day.

Nursing facilities will be exempt from payment of the assessment if they fall into any of the following categories:

1. Government-owned and operated nursing facilities
2. Veterans Administration nursing facilities.
3. Nursing facilities that have not been licensed and operated by the current or previous owner for the full calendar quarter prior to the calendar quarter for which an assessment is collected.
4. Nursing facilities that provide nursing facility services free of charge to all residents.

As in the first 5 years of the Assessment Program, nonexempt nursing facilities will continue to be assessed on a quarterly basis during FY 2011‐2012 based on the number of licensed beds in the facility, the nursing facility's CCRC or, county status, and the number of non‐Medicare resident days during each calendar quarter immediately preceding the assessment quarter. During FY 2011‐2012, the assessment rates for nonexempt facilities will be as follows:

1. The assessment rate for county nursing facilities, nursing facilities that either have 50 or fewer licensed beds and for grandfathered CCRC nursing facilities that have certified continued participation within that CCRC, will be $6.59 per non‐Medicare resident day.
2. The assessment rate for all other nonexempt nursing facilities will be $28.04 per non‐Medicare resident day.