Medicaid Nursing Home Reimbursement

Pension and Wage Increase

Enhanced Health Care and Pension Benefits for Nursing Facility Employees
Special Act 21-15 appropriated $15 million to the Department of Social Services, for Medicaid, for the fiscal year ending June 30, 2023 for the purpose of adjusting nursing home rates for facilities that provide enhanced health care and pension benefits for facility employees. Facilities that receive a rate adjustment for the purpose of providing enhanced health care and pension benefits for employees but do not provide such enhanced benefits may be subject to a rate decrease in the same amount as the adjustment by the Commissioner of Social Services. Total funding for the program is $30 million (state and federal). Available funding will be distributed pro-rata based on the cost of each facility's enhancements, final amounts will be adjusted for the Medicaid percentage of the facility. All applications have been received and amounts have been calculated.

Final Distribution File

FAQ March 2022

Direct Care Rate Increase
Public Act 21-185, established a nursing home minimum staffing level of three hours of direct care per resident per day. Public Act 21-2, June special session allocated up to $500,000 in state funding to the Department of Social Services, for Medicaid, for each of the fiscal years ending June 30, 2022 and June 30, 2023, to support the minimum nursing home staffing requirement. Nursing homes that are not currently providing such staffing may complete an application to be considered for a Medicaid rate increase to support a staffing increase up to the minimum.

Final Distribution File

Social Worker Rate Increase
Per Public Act 21-2, June special session, up to $2,500,000 in state funding has been allocated to the Department of Social Services, for Medicaid, for each of the fiscal years ending June 30, 2022 and June 30, 2023, for Social Worker staffing at nursing homes to meet the Department of Public Health (DPH) requirement. The DPH minimum staffing requirements for Social Workers in nursing facilities has been mandated to a minimum of one full time Social Worker per sixty beds. Nursing homes that are not currently providing such staffing may complete an application to be considered for a Medicaid rate increase to support a staffing increase up to the minimum.

July 28, 2021 - Information related to the 4.5% rate increases effective July, 1, 2021. Increases are to be use to support staff wages. 

Nursing Home FAQ #1 - responses to questions from the industry regarding the SFY22 and SFY23 financials support for nursing homes provided in the state budget

Nursing Home FAQ #2 - responses to questions from the industry wide town hall held on July 28, 2021


July 1, 2019 Nursing Home Wage Increase

July 1, 2019 Nursing Home Rate Increase Information - June 27, 2019

Frequently Asked Questions - June 27, 2019

November 1, 2018 Nursing Home Wage Increase
The Secretary of the Office of Policy and Management recently approved a 2% increase on nursing home rates effective November 1, 2018. The increase will be implemented by the Department of Social Services 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. This page will be dedicated to providing information regarding the 2% increase.

Notice to Nursing Homes - September 17, 2018
Frequently Asked Questions #1 - September 27, 2018
Frequently Asked Questions #2 - October 12, 2018
Frequently Asked Questions #3 - November 13, 2018