D.C. Mun. Regs. tit. 29, § 6508
Ventilator Care
Authority: An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat.744; Pub. L. 90-227, D.C. Official Code § 1-307.02 (2012 Repl. & 2013 Supp.)), and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)). Source: Final Rulemaking published at 53 DCR 1370 (February 24, 2006); as amended by Final Rulemaking published at 61 DCR 3795 (April 11, 2014); as amended by Final Rulemaking published at 64 DCR 784 (January 27, 2017); as amended by Final Rulemaking published at 66 DCR 13663 (October 18, 2019).District of Columbia, Office of the Secretary
6508 FINAL PER DIEM RATE CALULATION
6508.1 Each nursing facility's per diem rate effective January 1, 2006 shall be the sum of (a), (b) and (c) as set forth below:
- (a) the nursing and resident care base year cost per diem established pursuant to subsection 6505.6 adjusted for inflation to March 30, 2003 using the CMS Prospective Payment System Skilled Nursing Facility Input Price Index;
- (b) the routine and support cost base year cost per diem established pursuant to subsection 6506.3, or subsection 6506.4 if applicable, adjusted for inflation to March 30, 2003 using the CMS Prospective Payment System Skilled Nursing Facility Input Price Index; and
- (c) the capital related base year cost per diem established pursuant to section 6507 adjusted for inflation to March 30, 2003 using the CMS Prospective Payment System Skilled Nursing Facility Input Price Index. The inflation adjustment in this subsection shall not be applied to depreciation, amortization and interest on capital related expenditures.
6508.2 Effective April 1, 2006 and every six months thereafter, the nursing and resident care costs per diem shall be re-calculated in accordance with section 6505. The per diem rates established for routine and support costs and capital-related costs established pursuant to subsection 6508.1 shall be carried forward until costs are rebased.
6508.3 When necessary, each facility's per diem rate will be reduced by the same percentage to maintain compliance with the Medicare upper payment limit requirement.
6508.4 MAA may approve an adjustment to the facility's per diem rate if the facility demonstrates that it incurred higher costs due to extraordinary circumstances beyond its control including but not limited to strikes, fire flood, earthquake, or similar unusual occurrences with substantial cost effects.
6508.5 Each adjustment pursuant to subsection 6508.4 shall be made only to the extent the costs are reasonable, attributable to the circumstances specified, separately identified by the facility, and verified by MAA.
SOURCE: Final Rulemaking published at 53 DCR 1370 (February 24, 2006).