Reasonable Payable Rates 400-30-05-10

(Revised 7/02 ML #2804)

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North Dakota Administrative Code 75-02-07.1 requires the Department to establish payable rates for licensed basic care facilities. The Department’s Provider Audit Unit conducts an annual review or audit of basic care facility costs. The types of costs are similar to those recognized in nursing facilities.

 

Each facility’s rate is adjusted forward to the beginning of the basic care rate year, July 1. Adjustments include cost of living adjustments to the basic care facility’s audited costs. Prior to July 1, the Department establishes the reasonable rate for each facility that chooses to participate in this process.

 

The payable rate is expressed in terms of a daily rate which does not include the provision for a resident’s personal needs requirement of $60.00 per month. This allowance from a resident’s gross income is determined in the budgeting process as set forth in Service Chapter 400-29.

 

The Department makes all payments on behalf of eligible residents through the Medicaid Management Information System (MMIS). Only those licensed basic care facilities for whom the Department has determined a payable rate may receive a payment.