April 16, 2021
The January 1, 2021, through December 31, 2021, (calendar year 2021), facility-specific reimbursement rates for Freestanding Adult Subacute Skilled Nursing Facility Level B (FSSA/NF-B) are established effective for dates of service on or after January 1, 2021.
FSSA/NF-B facility-specific reimbursement rates are computed on an annual basis. The calendar year 2021 rates are posted on the Long-Term Care Reimbursement AB 1629 page of the Department of Health Care Services (DHCS) website.
In addition, the facility-specific rates include a temporary coronavirus disease 2019 (COVID-19) increased reimbursement amount of 10 percent, which is based on the facility’s prior 2019 – 2020 facility-specific rate. The 10 percent increase will be provided during the coronavirus public health emergency and national emergency and will end at the expiration of either emergency period. The temporary COVID-19 increased rates are also posted on the Long-Term Care Reimbursement AB 1629 page of the DHCS website.
Providers should use these rates to bill for dates of service on or after January 1, 2021.
No additional action is required of providers. An Erroneous Payment Correction (EPC) will be implemented to reprocess affected claims.
The calendar year 2021 rate period add-ons total $3.82. This includes Minimum Wage (January 2021, SB 3) $1.08, Minimum Wage (January 2020, SB 3) $0.86, Minimum Wage (January 2019, SB 3) $0.55, Standards of Participation: Infection Preventionist $1.31 and Lesbian Gay Bisexual Transgender (LGBT) $0.02.
Change of Ownership
Facilities with changes of ownership or changes of licensed operator do not qualify for facility-specific reimbursement rates and will continue to receive the prior owner’s or licensed operator’s rate, as applicable. For more information, refer to the “AB 1629 Facility-Specific Rate Methodology Clarifications” article on the DHCS website.
Leave of Absence/Bed Hold Reduction
The calendar year 2021 rate period reduction for Leave of Absence or Bed Hold is $8.73.
Quality Assurance Fee
The approved FSSA/NF-B Quality Assurance Fee (QAF) amount for facilities is $15.19.