Haw. Code R. § 17-1739-63

Current through November, 2024
Section 17-1739-63 - Calculation of base year prospective rates for classification I - nonpsychiatric services
(a) A base per diem rate for nonpsychiatric services for classification I facilities shall be established using the following general methodology:
(1) Deduct the capital related costs allocated to non-psychiatric services on the base year cost report;
(2) Calculate nonpsychiatric inpatient medicaid facility costs and days for all facilities in classification I by subtracting the facility's psychiatric costs and days for routine, special care, and ancillary services as specified in section 17-1739-62 from the facility's total allowable medicaid inpatient costs and days for routine, special care, and ancillary services as derived from the cost report and as calculated in section 17-1739-61; and
(3) Total the resulting costs, excluding capital related costs, and days for routine, special care, and ancillary services and achieve a facility-specific medicaid inpatient nonpsychiatric cost per day by dividing total nonpsychiatric medicaid costs by total nonpsychiatric inpatient medicaid days.
(b) The classification I per diem rate ceiling for nonpsychiatric services shall be calculated as follows:
(1) Total the costs, excluding capital related costs, and days for all nonpsychiatric services for all facilities in classification I, as identified in subsection (a);
(2) Divide total nonpsychiatric inpatient costs calculated in paragraph (1) by total nonpsychiatric inpatient days for all facilities in classification I; and
(3) Multiply the result of paragraph (2) by the nonpsychiatric classification I ceiling factor (one hundred twenty per cent) published annually by the department. This result shall be the classification I per diem rate ceiling for nonpsychiatric facilities.
(c) The prospective payment rate for classification I facilities shall equal the lesser of either the facility-specific per diem rates or the classification I per diem rate ceiling for nonpsychiatric inpatient services.

Haw. Code R. § 17-1739-63

[Eff 11/13/95] (Auth: HRS § 346-59) (Imp: 42 C.F.R. §447.252 )