AGING AND DISABILITY SERVICES ADMINISTRATION

2006 NH "Dear Administrator" Letters

June 30, 2006

ADSA: NH #2006-017
July 1, 2006 Medicaid Rates for Nursing Homes

Dear Nursing Facility/Home Administrator:

The July 1, 2006 Medicaid payment rate for your facility is enclosed. A copy of the "Description of July 1, 2006 Nursing Facility Medicaid Payment Rate Setting" which explains how your rate was calculated is enclosed for your conve­nience. In creating the rate computation worksheet, the Department used wording and calculation descrip­tions as similar as possible to that used in prior rate settings to facilitate your review.

The July 1, 2006 Medicaid payment rate is subject to administrative review in accordance with RCW 74.46.770 and WAC 388-96-901 and -904. To appeal this rate, you must submit a written request in writing within twenty-eight (28) calendar days after receiving this notice of the rate. The contractor or a partner, officer, or authorized employee of the contractor must sign the request for administrative review. The request must state the reasons for the appeal and include all necessary supporting documentation. The appeal should be mailed to the Office of Rates Management at the address above.

If proof of the date of receipt of the Department's rate notification letter exists, then that date shall be used to determine the timeliness of your request for an administrative review conference. If there is no proof of the date of receipt of the Department's rate notification letter, then you will be deemed to have received notice by July 5, 2006 in accordance with WAC 388-96-904 (1).

Also enclosed are an “Addendum for July 2006 Rate Setting,” “Reason Codes for Examination Adjustments,” an exhibit showing the change in case mix weights for the various RUG codes, an exhibit showing Direct Care and Operations median costs on a per patient day basis, an exhibit comparing the 2003 and 2005 home office lid adjustments, a list of Department personnel involved with nursing facility Medicaid payment, and a list of the analysts responsible for specific facilities' Medicaid rates. I encourage you to contact your analyst if you have questions about your rate.

Sincerely,

Bonnie M. Hawkins, Acting Chief
Office of Rates Management