Payment to Licensed Nursing Facilities 400-29-75-01
(Revised 2/02 ML #2785)
Participation in the Basic Care Assistance Program is voluntary. The nursing facility must be willing to accept the basic care limit rate established by the Department of Human Services as payment in full. A nursing facility must enroll as a basic care provider to receive basic care payments. Payments to the nursing facility will be for the total daily rate (personal care option and the room and board rate). The personal care option is not available for individual’s residing in a nursing facility in a basic care capacity.
If the basic care assistance appropriation is insufficient to pay the estimated supplements for individuals statewide, the rate payable may be reduced in accordance with NDAC § 75-02-07.1-22. A nursing facility providing services to a basic care resident is considered a new facility for purpose of determining a reduced rate. The reduced rate will be determined by the Department of Human Services. The nursing facility will be notified of a rate change 30 days before occurrence.
Basic care payments to a nursing facility will begin from the date of the initiation of the functional assessment or on the first day of the seventh month of residence whichever is later, if applicable. If an individual appeals the level of care determination, basic care payments will not be made until after the appeal decision. The basic care payments will be retroactive to the date of eligibility if the level of care determination is upheld.
