Section 1130.73. Additional payment for nursing facility residents

(a) An additional payment is made to a hospice for hospice care furnished to a MA recipient who is a resident of a skilled or intermediate care facility participating in the MA Program. The additional payment will take into account the cost of room and board. Room and board rates will be calculated as follows:

(1) Room and board cost data will be retrieved from the most recently audited cost reports of participating skilled nursing facilities.

(2) Appropriate inflation factors will be applied to each facility’s room and board cost as needed to bring it forward to Fiscal Year 1989-90.

(3) The costs will be grouped into Metropolitan Statistical Areas (MSAs) according to the location of the nursing facility.

(4) An average room and board per diem will be calculated for each group.

(5) A wage index appropriate to each MSA will be applied to the average room and board per diem to account for area differences in wages.