**DSS Field Offices are now open Monday, Tuesday, Thursday and Friday, from 8 a.m. to 4 p.m.

**DSS Field Offices and our staffed telephone Benefits Center (1-855-6-CONNECT or 1-855-626-6632) are closed on Wednesdays to allow our staff time to process applications, renewals and related work.

**24/7 access: Customers can access benefit and application information, at www.connect.ct.gov and www.ct.gov/dss/apply; or our automated Client Information Line at 1-855-6-CONNECT (1-855-626-6632). More about 24/7 access options at www.ct.gov/dss/fieldoffices.

Medicaid Nursing Home Reimbursement

Overview

NEW!  April 13, 2021 Announcement Letter The Office of Policy and Management and the Department of Social Services have announced financial supports for nursing facilities. Supports include:
  • crediting homes for financial incentives provided to direct care staff since July 1, 2020;
  • 5% rate increase from April 1, 2021 through June 30, 2021;
  • continuation of state coverage of costs for nursing home testing, in accordance with Department of Public Health (DPH) guidance, through June 30, 2021; and
  • deferral of the phased-in implementation of acuity-based rates, from July 1, 2021 to October 1, 2021.
To receive the 5% rate increase for April 1, 2021 to June 30, 2021, each nursing home must:
  1. Complete the Acknowledgement and Acceptance of Terms
  2. Nursing homes that do not sign and return this document will not be eligible for a rate increase.
  3. Return the signed document to the Department at: con-ratesetting.dss@ct.gov
February 2021 - COVID-19 Financial Supports Package
Coronavirus Relief Fund (CRF) Grant Payments to Qualifying Nursing Home Providers are made 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). On December 30, 2020, the Office of Policy and Management and the Department of Social Services announced financial supports for nursing facilities in response to the COVID-19 pandemic. Supports will be implemented in two-phases and are designed to meet specific criteria, standards, and conditions to improve infection control for COVID-19 and other infectious diseases in long-term care settings.

A nursing home that wishes to receive funding must download, carefully review, and complete the forms below. Please complete and return to the Department the 'Signature and Attestation Form’ (PDF) and ‘Short Period Cost Report’ (Excel). The short period cost report is not the typical cost report filed annually by nursing facilities, but is specifically related to this COVID financial supports package. Please complete and return to the Department by emailing completed documents to: con-ratesetting.dss@ct.gov

DSS will process submissions of CRF grant documents on a continuous basis and will make grant payments on a rolling, weekly basis, with best efforts to make the payments early the week subsequent to submission of a complete package of documents. The November and December payments will be issued as a one-time CRF grant payment. The increases for January, February, and March will be issued through the Medicaid rate.

Application Submission Deadline Extended to April 20, 2021 -The application submission deadline has been extended from March 17, 2021 to April 20, 2021. Based on feedback from the provider community and to allow for as many homes as possible to apply for financial supports, the deadline has been extended to April 20, 2021. 

December 30, 2020 Announcement Letter
Signature and Attestation Form
Short Period Cost Report
Grant Distribution List
Rate Increases January to March 2021
FAQ Document (Revised 3/1/2021)
COVID-19 Temporary Rate Increase Letter

February 26, 2021 - Notice to Nursing Home Administrators
Information on the Economic Impact Payments or "stimulus payments" made to nursing home residents. 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. The deadline to file an application for CRF grants has been extended to August 14, 2020.

March 2020 - 10% Medicaid Rate Increases Effective March 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.

April 3, 2020 - April Nursing Facility Rate Increases by Provider Increases were effective April 1 - April 30, 2020

June 3, 2020Notice 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 209 nursing homes and 24,522 licensed beds in Connecticut. Medicaid is the funding source for approximately 74% of nursing home care in Connecticut. Nursing facility rates and census information is available by individual facility. Nursing facility annual cost reports are also available.

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.

Wage Increase
Rate increases will be implemented by the Department of Social Services (the Department) and is specifically intended to support a permanent increase 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
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.

 Payor Mix  2018  2019  2020
Medicaid  73.91% 74.09%  72.60%
Medicare  11.5% 10.25%  12.08%
Private Pay  9.99% 9.94% 9.97% 
Other (Veterans/Medicaid Other States)  4.6% 5.72%  5.35%


Key Areas of Focus