Reimbursement

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SNF Medicaid Rates – SFYQ2

The Division of Rate Setting has announced their Q2 nursing home rates. In these updated rates, the PDPM to RUG IV ratio moves to 50-50 for calculating case mix index. Across 32 facilities, 2 were limited by a private pay cap. Excluding facilities currently or previously (Q1) limited by private pay rates, 9 saw a rate increase from Q1, while 15 had rates decrease. The largest increase (excluding EFR & private pay adjustment) was $10.40 while the largest decrease was $12.61. The average rate (adjusted for EFR and excluding the Vermont Veterans Home) was $373.15.

PDPM Transition Update

On October 2, VHCA hosted Zimmet Healthcare Services Group to present a daylong training on successful Medicaid PDPM transitions.

For details on how to use the PDPM patient portal for Vermont Medicaid, see the Myers & Stauffer Provider Materials.