Section R9-28-702. Nursing Facility Assessment

A.      For purposes of R9-28-702 and R9-28-703, in addition to the definitions under  A.R.S.  3 6-2999.51, the following terms have the following meaning unless the context specifically requires another meaning:

“820 transaction” means the standard health care pre- mium payments transaction required by 45 CFR 162.1702.

“Assessment year” means the 12 month period beginning October 1st each year

“Medicaid patient days” means patient days reported on the Nursing Care Institution Uniform Accounting Report (UAR) as attributable to AHCCCS and its contractors as the primary payor.

“Medicare patient days” means patient days reported on the Nursing Care Institution UAR as Skilled Medicare Patient Days or Part C/Advantage/Medicare Replacement Days.

“Nursing Care Institution UAR” means the Nursing Care Institution Uniform Accounting Report described by R9- 11-204.

B.       Subject to Centers for Medicare and Medicaid Services (CMS) approval, effective October 1, 2012, nursing facilities shall be subject to a provider assessment payable on a quarterly basis.

C.      All nursing facilities licensed in the state of Arizona shall be subject to the provider assessment except for:

1.        A continuing care retirement community,

2.        A facility with 58 or fewer beds, according to the Arizona Department of Health Services, Division of Licensing Services, Provider & Facility Database,

3.        A facility designated by the Arizona Department of Health Services as an Intermediate Care Facility for the Intellectually Disabled,

4.        A tribally owned or operated facility located on a reserva- tion, or

5.        Arizona Veteran’s Homes.

D.      The Administration shall  calculate  the prospective nursing facility provider assessment for qualifying nursing facilities as follows:

1.        In  September   of  each  year,  the  Administration   shall obtain from the Arizona Department of Health Services

the most recently published Nursing Care Institution UAR and the information required in subsection (C)(2). At the request of the Administration, a nursing facility shall provide the Administration with any additional information necessary to determine the assessment.

2.        The Administration shall use the information obtained under subsection (D)(1) to determine:

a.         Each nursing facility’s total annual Medicaid patient days,

b.        Each nursing facility’s total annual Medicare patient days,

c.         Each nursing facility’s total annual patient days,

d.        The  aggregate  net  patient  service  revenue  of  all assessed providers, and

e.         The slope described under 42 CFR 433.68(e)(2).

3.        For each nursing facility, other than a nursing facility exempted in subsection (C) or described in subsection (D)(4), the provider assessment is calculated by multiply- ing the nursing facility’s total annual patient days other than Medicare patient days by $10.50.

4.        For a nursing facility, other than a nursing facility exempted in subsection (C), with a number of total annual Medicaid patient days greater than or equal to the number required to achieve a slope of at least 1 applying the uniformity tax waiver test described in 42 CFR 433.68(e)(2), the provider assessment is calculated by multiplying the nursing facility’s total annual patient days, other than Medicare patient days, by $1.40.

5.        For each assessment year the slope described under 42 CFR 433.68(e)(2) shall be recalculated.

6.        The total annual assessment calculated under subsections (D)(3), (D)(4) and (D)(5), shall not exceed 3.5 percent of the aggregate net patient service revenue of all assessed providers as  reported  on the  Nursing  Care Institution UAR obtained under subsection (D)(1).

7.        All calculations and determinations necessary for the pro- vider assessment shall be based on information possessed by the Administration on or before November 1 of the assessment year.

8.        The Administration shall forward the provider assess- ments for all assessed facilities to the Arizona Depart- ment of Revenue by no later than December 1 of the assessment year.

9.        In the event a nursing facility closes during the assess- ment year, the nursing facility shall cease to be responsi- ble for the portion of the assessment applied to the dates the nursing facility is not operating.

10.     In the event a nursing facility begins operation during the assessment year, that facility will have no responsibility for the assessment until such time as the facility has sub- mitted to the Arizona Department of Health Services the report required by R9-11-204(A) covering a full year of operation.

11.     In the event a nursing facility has a change of ownership such that the facility remains open and the ownership of the facility changes, the assessment liability  transfers with the change in ownership.

Historical Note

Adopted effective October 1, 1988, filed September 1,

1988 (Supp. 88-3). Amended effective September 22,

1997 (Supp. 97-3). Amended by final rulemaking at 8

A.A.R. 3340, effective July 15, 2002 (Supp. 02-3). Amended by final rulemaking at 11 A.A.R. 3244, effec- tive October 1, 2005 (Supp. 05-3). Section repealed by

final rulemaking at 13 A.A.R. 458, effective April 7, 2007 (Supp. 07-1). New Section made by final rulemak-

ing at 19 A.A.R. 137, effective January 8, 2013 (Supp.

13-1). Amended by final rulemaking at 19 A.A.R. 4168,

effective February 1, 2014 (Supp. 13-4). Amended by final rulemaking at 20 A.A.R. 1989, effective September 6, 2014 (Supp. 14-3).