DOH Monthly Briefing – Finance – October 2017

Carl J. Pucci in Finance & Reimbursement

DOH held its monthly briefing earlier today. The following is a brief summary of the topics discussed:

Minimum Wage Survey – Contracted Staff

NYSHFA’s efforts to advocate for inclusion of contracted staff with DOB was successful, as DOH will be issuing a separate survey to capture contracted staff cost information. The survey is expected to be released in the next week or so, and will have a two-week turnaround. It is vital that any facility utilizing direct care contracted staff respond by the applicable due date in order to ensure proper reimbursement in their 1/1/18 rates.

Capital Attestations

The 2018 Capital Attestation’s are due this Friday, October 13, 2017. A reminder that the attestation filing is mandatory for all nursing homes! DOH does not plan on any capital supplemental rate packages during 1st Qtr 2018; as such, this remains the only opportunity (short of a lengthy appeal process) to verify and correct the accuracy of your 1/1/18 capital rate.

Case Mix

The July 2017 census date and roster submissions concluded on September 29, 2017. DOH reported that all facilities successfully submitted their MDS rosters. They fully anticipate the 7/1/17 MDS update to be included in the 1/1/18 initial rates. Optimally, the MDS update could even be reflected as early as the 11/1/17 notice rates, but no guarantees were given.

OMIG Audits

The 2014 MDS audits have been approved by DOB. The revised 7/1/14 and 1/1/15 rates, including release of the 5% CMI cap, will be forwarded to EMEDNY for payment within the next two Medicaid rate cycles. The corresponding rate revisions will be posted concurrently with the EMEDNY payments.

The 2015 MDS audits are being initiated by OMIG in the next few weeks. OMIG anticipates approximately 200 facilities will be audited (down from 250 in 2014) beginning in the western part of the state. OMIG will again combine the January and July 2015 MDS submission periods for audit. OMIG noted an increase in audit findings and related dollar impact from the 2014 audit results (over 2013), primarily in therapy increases and related documentation issues. Discussions then centered on further MDS education based on historical OMIG audit findings. DOH will contact the School of Public Health for possible MDS webinar training to assist providers going forward with respect to OMIG MDS audit preparation.

Nursing Home Remittance Reports

As previously noted, the FMG/Medical Financial Management FoxPro Reports were discontinued recently. NYSHFA has advocated for restoration of the reports, and DOH is meeting internally this week to further discuss.

2016 CRA Reconciliation

The 2016 Cash Receipt Assessment Reconciliation is expected to be finalized during 4th Qtr 2017. The Associations once again advocated for an update to the 2014 billing per diem.

NYSHFA will keep members updated on these issues going forward.


Carl J. Pucci
Chief Financial Officer
518-462-4800 x36