This text of North Dakota § 50-24.4-10 (Operating costs) is published on Counsel Stack Legal Research, covering North Dakota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
1.The department shall establish procedures for determining per diem reimbursement
for operating costs.
2.The department shall analyze and evaluate each nursing home's cost report of
allowable operating costs incurred by the nursing home during the reporting year
immediately preceding the rate year for which the payment rate becomes effective.
3.The department shall establish price limits on actual allowable historical operating cost
per diems, increased by the market basket for skilled nursing facility before
productivity assessment, based on cost reports of allowable operating costs taking into
consideration relevant factors including resident needs, nursing hours necessary to
meet resident needs, size of the nursing home, and the costs that must be incurred for
the care of residents
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1. The department shall establish procedures for determining per diem reimbursement
for operating costs.
2. The department shall analyze and evaluate each nursing home's cost report of
allowable operating costs incurred by the nursing home during the reporting year
immediately preceding the rate year for which the payment rate becomes effective.
3. The department shall establish price limits on actual allowable historical operating cost
per diems, increased by the market basket for skilled nursing facility before
productivity assessment, based on cost reports of allowable operating costs taking into
consideration relevant factors including resident needs, nursing hours necessary to
meet resident needs, size of the nursing home, and the costs that must be incurred for
the care of residents in an efficiently and economically operated nursing home. For the
rate year beginning 2022, the department shall establish price limits for cost categories
using the June 30, 2021, cost report year as the base period. The price limits must be
established using the same percentage of the median used to establish the limits for
the June 30, 2020, base period. In determining allowable historical operating cost per
diems for purposes of setting price limits, the department shall divide the allowable
historical operating costs by the actual number of resident days, except that when a
nursing home is occupied at less than ninety percent of licensed capacity days, the
department may establish procedures to adjust the computation of the indirect care
cost per diem to an imputed occupancy level at or below ninety percent. To encourage
the development of home and community-based services as an alternative to nursing
home care, the department may waive the imputed occupancy level requirements for a
nursing home that the department determines to be providing significant home and
community-based services in coordination with home and community-based service
providers to avoid duplicating existing services.
4. In establishing payment rates for one or more operating cost categories, the
department may establish separate rates for different classes of residents based on
their relative care needs.
5. The department shall include in the ratesetting system for nursing homes those costs
associated with computer software and any related technology, including cloud-based
services. These expenses are allowed as a direct passthrough.
6. A new base period must be established with the cost report period June 30, 2023.
7. The margin cap used for the rate year beginning 2022 price limits must be no less than
three and forty-six hundredths percent.
8. The market basket for skilled nursing facility before productivity adjustment is the
preferred index to adjust historical operating costs when a new base period is
established and to adjust the price rate in subsequent years until a new base rate
period is established.
9. For the rate years beginning 2022 and 2023, the department shall inform the nursing
home of the operating rate using historical operating costs and the operating rate
using price limits. The nursing home shall inform the department if the nursing home
wants to accept the operating rate using historical operating costs as the established
rate.