Volume 42 - Issue 35 - August 31, 2023
State of Kansas
Department for Aging and Disability Services
Request for Comment
The following Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) cost center limits are being set forth for public comment. Comments should be sent to Sheri Jurad, Director of Nursing Facility and Adult Care Home Programs, 503 Kansas Ave., Topeka, KS 66603. The comment period will expire 30 days from the publication of this notice.
K.A.R. 30-10-214 provides for the annual review and adjustment of Class II ICF-IID cost center limits, approved by the secretary of the Kansas Department for Aging and Disability Services (KDADS) or designee, based on current cost information supplied by the enrolled, licensed providers of ICF-IID services, and formula set forth in the Kansas State Medicaid Plan (Attachment 4.19-D, Part II, Subpart O). The formula is as follows: Total allowable costs, including an inflation factor, are compared to the amount to be reimbursed under the current limits.
The formula threshold requires that 60 percent of all ICF-IIDs are reimbursed 90 percent of their allowable costs. If less than 60 percent of the facilities are reimbursed at 90 percent of their allowable costs, then the cost center limits are adjusted until the threshold is met. The inflation factor is based on the IHS Global Insight, National Skilled Nursing Facility Market Basket Without Capital Index (IHS Index).
To determine where to make the adjustments, two major cost centers are analyzed according to the following prescription:
- Administrative costs are based on facility size.
- Habilitation costs are based on facility size and level of care (LOC).
The cost analysis for SFY2024 demonstrates 87.5 percent of the Class II ICF-IIDs are being reimbursed at 90 percent or more of their allowable costs. Per the state plan, the analysis indicates that adjustments are not required.
Recommendations
Based on cost report analysis, available funding and to incentivize providers that care for high acuity residents, two additional habilitation levels are being added and cost center limits for Class II ICF-IIDs are as follows:
| Levels | Converted DDP Scores |
|---|---|
| Level I | 225-and up |
| Level II | 200-224.99 |
| Level III | 175-199.99 |
| Level IV | 150-174.99 |
| Level V | 125-149.99 |
| Level VI | 100-124.99 |
| Level VII | 75-99.99 |
Facility
| Size | Level I | Level II | Level III | Level IV | Level V | Level VI | Level VII | |
|---|---|---|---|---|---|---|---|---|
| A. | +16 beds | $224.65 | $197.06 | $172.86 | $164.71 | $156.98 | $149.64 | $142.65 |
| B. | 9-16 beds | $278.91 | $244.66 | $214.61 | $204.40 | $194.68 | $185.46 | $176.67 |
| C. | 4-8 beds | $324.11 | $284.30 | $249.39 | $237.42 | $226.04 | $215.24 | $204.98 |
Administrative per diem limits are based on the size of the facility, using the same classes as referred to above.
Administrative Per Diem Limits
- $26.92
- $44.68
- $50.18
Fiscal Impact
Due to changes to inflation factors and per diem limits, the estimated annual cost increase is $288,350.
Laura Howard
Secretary
Department for Aging and Disability Services
Doc. No. 051451
