New Medi-Cal Rates for Skilled Nursing Facilities

January 4, 2018

Rates are retroactive to 8/1/2017

The State of California has posted FINAL Medi-Cal reimbursement rates for Skilled Nursing Facilities which are retroactive to August 1, 2017.  Highlights of the changes include:

  • An across-the-board, mandated pass-through of $1.39 per day for mandated new costs (see below for breakdown).
  • The new Quality Assurance (QA) fee is $15.38 per day (for facilities with less than 100,000 days per year), down from $15.95.
  • The QA fee has been reduced to help offset the increase in licensing fees.  Effective July 2017, SNF licensing fees are $606.17 per bed.
  • The new Bed Hold rate is $7.65 per day, up from $7.35.

Notes regarding the final rates provided:

  1. Now that the final rates have been published, the State will be comparing each facility's new rate with the previous final rate that was paid from August 2017.
  2. For facilities that have an increase above the previous final rate, a lump sum will be calculated and paid based on the number of Medi-Cal patient days paid.
  3. For facilities that have a reduction from the previous final rate, a calculation will be made of the over-payment.  Typically, over-payments are recovered at a rate of 5% of the total from each succeeding check write, however we do not have confirmation of this yet.
  4. On average, it takes the State approximately 7-10 months to pay/recover facility payments.

Facilities receiving payments for Medi-Cal residents from Managed Care plans should receive the new rates.  We have no information yet regarding any individual plan's intentions regarding timing of new payments.

Sub-Acute Rates
The State has also posted new Sub-Acute rates, which will be retroactive to 8/1/2017.  The across the board pass-through of $1.39 per day for mandated new costs also apply to the Sub-Acute rates (see below for breakdown).

Institutions for Mental Disease
The State included the following additional rates:

  • 2016/17 Federal Unemployment Tax Act (FUTA, $0.05)
  • 2017/18 FUTA ($0.05)
  • 2016 Minimum Wage AB 10 ($0.15)
  • 2017 Minimum Wage SB 3 ($0.17)
  • 2018 Minimum Wage SB 3 ($0.78)
  • Payroll Based Journal ($0.13)
  • Standards of participation ($0.04)

Please note:  Mueller Prost rate estimates issued during cost report time are not based on any state interim rates issued, but on final rates issued from year-to-year.  The final rates listed above can be compared to your rate issued in 2016/17, plus your issued Medi-Cal audited adjustments.

Rate Schedule Downloads (from the California Department of Health Care Services): 

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