Nursing Home Quality

Quality of Care Fund Assessments

  1. The OHCA was mandated by the Oklahoma Legislature to assess a monthly service fee to each licensed nursing facility in the state. The fee is assessed on a per patient day basis. The amount of the fee is uniform for each facility type. The fee is determined as six percent (6%) of the average total gross receipts divided by the total days for each facility type.
     
  2. Annually, the Nursing Facilities Quality of Care Fee shall be determined by using the daily patient census and patient gross receipts report received by the OHCA for the most recent available twelve months and annualizing those figures. Also, the fee will be monitored to never surpass the federal maximum.
     
  3. The fee is authorized through the Medicaid State Plan and by the Centers for Medicare and Medicaid Services regarding waiver of uniformity requirements related to the fee.
     
  4. Monthly reports of Gross Receipts and Census are included in the monthly Quality of Care Report. The data required includes, but is not limited to, the Total Gross Receipts and Total Patient Days for the current monthly report.
     
  5. The method of collection is as follows:
     
    1. The OHCA assesses each facility monthly based on the reported patient days from the Quality of Care Report filed two months prior to the month of the fee assessment billing. As defined in this subsection, the total assessment is the fee times the total days of service. The OHCA notifies the facility of its assessment by the end of the month of the Quality of Care Report submission date.
       
    2. Payment is due to the OHCA by the 15th of the following month. Failure to pay the amount by the 15th or failure to have the payment mailing postmarked by the 13th will result in a debt to the State of Oklahoma and is subject to penalties of 10 percent (10%) of the amount and interest of 1.25 percent (1.25%) per month. The Quality of Care Fee must be submitted no later than the 15th of the month. If the 15th falls upon a holiday or weekend (Saturday-Sunday), the fee is due by 5 p.m., Central Standard Time (CST), of the following business day (Monday-Friday).
       
    3. The monthly assessment, including applicable penalties and interest, must be paid regardless of any appeals action requested by the facility. If a provider fails to pay the OHCA the assessment within the time frames noted on the second invoice to the provider, the assessment, applicable penalty, and interest will be deducted from the facility's payment. Any change in payment amount resulting from an appeals decision will be adjusted in future payments. Adjustments to prior months' reported amounts for gross receipts or patient days may be made by filing an amended part C of the Quality of Care Report.
       
    4. The Quality of Care fee assessments excluding penalties and interest are an allowable cost for OHCA cost reporting purposes.
       
    5. The Quality of Care fund, which contains assessments collected including penalties and  interest as described in this subsection and any interest attributable to investment of any money in the fund, must be deposited in a revolving fund established in the State Treasury. The funds will be used pursuant to Section 2002 of Title 56 of the Oklahoma Statutes.
 

Reporting of Coronavirus Aid, Relief, and Economic Security (CARES) Act Funds on the Monthly Quality of Care Report

The following guidance pertains to reporting of CARES Act funds as gross receipts on the monthly Quality of Care Report submitted by long-term care facilities to the Oklahoma Health Care Authority.

  1. Medicare Accelerated and Advance Payments-these payments should not be included in gross receipts.
     
  2. Paycheck Protection Program Loan Guarantee-funds from this program should not be included in gross receipts.
     
  3. Provider Relief Fund Grants-If the provider receives funds and attest to such within 30 days after receipt of the funds, these payments should be included in gross receiptsProvider Relief Fund Grants-If the provider receives funds and attest to such within 30 days after receipt of the funds, these payments should be included in gross receipts