About Nursing Facilities

The Nursing Facilities function allows you, the provider of a nursing facility, to enter your census data and fiscal year's cost report online. Nursing facilities that don't have access to the Internet can mail in their census data and cost reports to have them entered by the Fiscal Agent Staff for New Hampshire, if prior arrangements are made.

The census is used in conjunction with the cost report, the Minimum Data Set (MDS) data, and claims history to calculate the daily rate New Hampshire pays for Medicaid recipients receiving care in a nursing facility. The process that does this calculation is called Acuity Rate Setting.

Not all nursing facilities have their rates automatically calculated using the Acuity Rate Setting process. For example, out of state nursing facilities' rates are calculated manually.

Nursing facility home offices enroll as group providers, with affiliation to their individual facilities. Nursing facility home offices are not allowed to actually submit claims. The home office is classified as a Non-billing Nursing Facility Home Office and not considered as part of the Acuity Rate Setting process. Their individual nursing facilities are included in the Acuity Rate Setting process, depending on the type of nursing facility.

The high level steps in the rate setting process time line are:

1. Census Submission
   • Census Picture Date provided to Nursing Facility Provider
   • Nursing Facility provider updates and submits
2. Initial Census Reconciliation
   • MDS data captured
   • Census reconciled to MDS data
   • Providers notified regarding Acuity
   • Providers provide feedback
   • Second capture of MDS data
   • Acuity confirmed
3. Rate Calculation
   • Case Mix Index calculated
   • Preliminary rates calculated
   • State review done
   • Final rates calculated
4. Provider Notice Period
   • Providers notified of proposed rates
   • Census picture date provided for next rate setting
   • Final rates become effective

See Also