36-2999.55. Adjustment of payments; definition

(Rpld. 10/1/31)

A. A nursing facility is eligible for quarterly nursing facility adjustments based on nursing facility days from the most recent cost report before the start of the fiscal year.  If cost report data is unavailable for a nursing facility, the administration may use other data sources or request patient day information from the facility to estimate nursing facility days.

B. The administration shall make adjustment payments on a quarterly basis to reimburse the medicaid portion of the assessment and other covered medicaid expenditures in the aggregate within the upper payment limit.  Each quarterly payment shall be made not later than thirty days after the end of the calendar quarter with the initial adjustment payment due within thirty days after approval by the centers for medicare and medicaid services of the quality assessment waiver and state plan reflecting the nursing facility adjusted payments.

C. Subject to approval by the centers for medicare and medicaid services, a nursing facility that is located outside of this state may not receive payments pursuant to this article.

D. For the purposes of this section, "nursing facility days" means the days of nursing facility services, including bed hold days, paid for by the Arizona medical assistance program for the applicable state fiscal year.