OverviewDSS Nursing Home Medicaid Rate Actions Related to COVID-19
Coronavirus Relief Fund (CRF) Grant Payments to Qualifying Nursing Home Providers
In accordance with Governor Lamont's Executive Order No. 7NN, Sections 5, 7, and 8, and Section 17b-11 of the Connecticut General Statutes, the Department will make Coronavirus Relief Fund (CRF) grant payments to all qualifying nursing home providers that are enrolled in good standing in the Connecticut Medical Assistance Program (CMAP).
All nursing home providers who wish to receive CRF grant payments shall complete and sign the forms below for the periods March 1 through April 30, 2020, and May 1 through June 30, 2020. All completed forms must be submitted to the DSS Office of Reimbursement and Certificate of Need at email@example.com.
The completed and signed CRF Payment Form must be received before DSS can process any CRF payments and should be submitted as soon as possible, but no later than July 31, 2020. The Cost Report form is due as soon as possible, but no later than thirty days after the close of each applicable reporting period. Please download and read each of the following documents carefully for instructions and terms.
Updated July 1, 2020 Frequently Asked Questions (FAQ) - This document features important information on CRF grant payments, amount determinations, and guidance on the completion of grant applications.
- Department Cover Letter
- CRF Payment Form Updated July 1, 2020 - Each nursing home provider must download and complete this form and return to the Department.
- Attestations, Cost Report, Hardship - This is a combined Excel file that providers are required to complete and return to the Department.
- CRF Amounts by Provider
- DSS Standards - This document outlines the details of CRF payments and associated conditions.
10% Medicaid Rate Increases Effective March 1, 2020 through March 31, 2020 - Under existing statutory authority, the Department of Social Services has implemented a 10% Medicaid rate increase effective March 1, 2020 through March 31, 2020 and issued $11.8 million in advances related to that period. This additional reimbursement is required to be applied towards: (a) employee wages, including staff retention bonuses, overtime, and shift incentive; (b) new costs related to screening of visitors, PPE, and cleaning and housekeeping supplies; and (c) other COVID-related costs.
June 3, 2020 - Notice to Nursing Home Administrators
Information on the Economic Impact Payments or "stimulus payments" made to nursing home residents.
Nursing Facility Information
The Office of Reimbursement and Certificate of Need (CON) is responsible for establishing Medicaid reimbursement methodologies for Medicaid nursing homes. Reimbursement and CON is responsible for Medicaid State Plan Amendments that are necessary to obtain Federal matching funds for nursing home services provided through Connecticut's Medicaid program. There are currently 222 nursing homes and 26,445 licensed beds in Connecticut. Medicaid is the funding source for approximately 72.3% of nursing home care in Connecticut.
Nursing Home Bed Reduction Process
The Department is responsible for the Certificate of Need (CON) process for nursing homes. A Nursing Home, or Applicant, may request a decrease in total bed capacity by submitting a letter of Intent for a Certificate of Need (CON) to the Commissioner of the Department of Social Services. Please visit the Bed Reduction page for more information.
Rate increases will be implemented by the Department of Social Services (the Department) and is specifically intended to support a permanent increase of no less than 2% to the compensation of employees directly employed by the nursing home. Please visit the Wage Increase page for more information.
Transition to Acuity-Based Methodology for Medicaid Reimbursement of Nursing Facilities
The Connecticut Department of Social Services will be transitioning Medicaid nursing facility reimbursement from a cost-based methodology to a prospective acuity-based or case mix payment system. This method will aid DSS in its goals of moving toward a system that is data driven, improves transparency, and benefits patient outcomes. View the Acuity Based Methodology page for additional information and updates.
Connecticut Nursing Facility Payer Mix - 2016
Under the Connecticut Medicaid program, payment rates for nursing homes are set on a cost-based prospective basis in accordance with Section 17b-340 of the Connecticut General Statutes and Section 17-311-52 of the Regulations of Connecticut State Agencies. The federal government provides states discretion in determining the method used to pay for nursing facility services. The state's reimbursement methodology, however, must be approved by the Centers for Medicare and Medicaid Services (CMS) within the federal Department of Health and Human Services. The annual rate period for nursing homes is July 1 through June 30, unless modified by the legislature. The cost reporting period, however, is October 1 through September 30. Every Medicaid nursing home must complete an "Annual Report of Long-Term Care Facility" which is annually due before February 15th.
|Other (Veterans/N.Y. Medicaid)||4.4%|
Key Areas of Focus
- The Annual Report of Long-Term Care Facility template and other supporting information can be found at Myers and Stauffer. The cost report captures detailed cost, statistical (e.g. residents days, therapy service volume, nursing hours) and ownership/related party transaction information.
- For the current rate period, July 1, 2017 through June 30, 2018, the statewide CCNH average Medicaid rate is approximately $234.09 per day for all non-specialized facilities. In SFY 2017, Medicaid expenditures for nursing facility services totaled approximately $1.2 billion.
- The Center for Medicare and Medicaid Services (CMS) Nursing compares Long Term Care Facilities by location, facility size, ownership type, resident needs, inspection results and nursing home staff.
- Medicaid Applications for Long-Term Services and Supports