N.Y. Comp. Codes R. & Regs. Tit. 10 §§ 86-7.2 - Computation of the rate of payment
(a) For each region, a rate of payment shall
be established for each of the 16 patient classification groups. The rate of
payment shall be established for the calendar year 1992. For each subsequent
calendar year, the 1992 rate of payment shall be increased by a roll factor as
determined pursuant to section
86-7.3
of this Subpart.
(b)
(1) For purposes of this Subpart, the rate of
payment shall be related to an average residential health care facility rate
consisting of two components:
(i) direct
component; and
(ii) other than
direct component.
(2)
Direct component of the rate of payment:
(i)
The direct component of the rate of payment shall be composed of costs incurred
in providing care directly to patients as set forth in section 86- 2.10(c)(1)
of this Part.
(ii) The direct
component for each patient classification group shall be equal to the statewide
mean direct case mix neutral cost, as determined in section
86-2.10(c)(3)
of this Part, times the case mix index for the patient classification group
divided by a regional direct input price adjustment factor for the patient
classification group as identified in subparagraph (iii) of this paragraph and
trended to 1992 by the applicable weighted average regional roll factor as
determined pursuant to section
86-7.3
of this Subpart. The case mix index for each patient classification group shall
be as identified in Appendix 13-A, infra, however, the case mix index for
reduced physical functioning A shall be.4414 as identified in section
86-2.10(c)(3)(iii)(i)
of this Part.
(iii) The regional
direct input price adjustment factor (RDIPAF) shall adjust for differences in
wage and fringe benefit costs between and among the regions caused by
differences in the wage scale of each level of employee. Within each region, a
RDIPAF shall be calculated for each patient classification group. The RDIPAF
shall be based upon the following factors:
(a)
Sixteen regions within the State as identified in Appendix 13-A,
infra.
(b) Case mix predicted
staffing for registered professional nurses, licensed practical nurses and
aides, orderlies and assistants for each patient classification
group.
(c) The proportion of
residential health care facility salaries and fringe benefit costs for the
direct care cost centers identified in section 86- 2.10(c)(1) of this Part to
the total costs of the direct care cost centers.
(d) A regional average dollar per hour and
proportion of regional direct salaries and fringe benefits to total direct
costs as identified in clause (c) of this subparagraph based upon either 1983
or 1987 residential health care facility financial and statistical data in
accordance with section 86- 2.10(m)(1)(iv) of this Part.
(3) Other than direct component of
the rate of payment:
(i) The other than
direct component shall be equal to the mean indirect price per day set forth in
section
86-2.10(d)(4)
of this Part for the freestanding, low intensity, less than 300 beds peer group
divided by the regional indirect input price adjustment factor for the patient
classification group as identified in subparagraph (ii) of this paragraph and
trended to 1992 by the applicable weighted average regional roll factor as
determined pursuant to section
86-7.3
of this Subpart plus a 1992 regional weighted average per diem for other than
direct and indirect components of the RHCF rate as set forth in section
86-2.10(f),
(g) and (r) of this Part, computed using the
first January 1, 1992 rate promulgated following the 30-day period established
for correcting errors in the initial January 1, 1992 rate issued at least 60
days prior to January 1, 1992.
(ii)
The regional indirect input price adjustment factor (RIIPAF) shall adjust for
differences in wage and fringe benefit costs between and among the wage
equalization factor regions caused by differences in the wage scale of each
level of employee. Within each region, a RIIPAF shall be calculated for each
patient classification group. The RIIPAF shall be based upon the following
factors:
(a) Sixteen regions within the
State, as identified in Appendix 13-A, infra.
(b) Case mix predicted staffing for
registered professional nurses, licensed practical nurses and aides, orderlies
and assistants for each patient classification group.
(c) The proportion of regional RHCF salaries
and fringe benefit costs for the indirect cost centers identified in section
86-2.10(d)(1)
of this Part to the total costs of the indirect care cost centers.
(d) A regional average dollar per hour and
proportion of regional indirect salaries and fringe benefits to total indirect
costs as identified in clause (c) of this subparagraph based upon either 1983
or 1987 residential health care facility financial and statistical data in
accordance with section 86- 2.10(m)(1)(iv) of this Part.
(c) For calendar year
1992, for each patient classification group in each region, the direct and
other than direct components shall be summed and multiplied by 50 percent. For
subsequent calendar years, the 1992 rate of payment shall be increased by the
applicable roll factor determined pursuant to section
86-7.3(b)
of this Subpart.
Notes
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