This measure is important because due to the heightened needs of the patients that these special rates serve, it is important that the special rates are set in a timely manner to ensure that residents can transfer from hospitals to nursing facilities without delay.  These special rates serve as an incentive for nursing facilities to accept residents requiring extraordinarily high levels of care.

DRS sets three different types of special rates in accordance with the Division’s rules to compensate nursing facilities for their increased costs and/or risk of taking these three types of exceptional residents close to the time that services are provided.  Without the special rates, any additional costs would be rolled in with the facilities’ other costs and included in the normal rate-setting process.  It may take up to four years for these costs to be reflected in their per diem rate as there is a lag between when costs are incurred in a base year cost and when they are reflected in the per diem rate.  Due to this, many nursing homes will only decide to accept special rate residents once the special rate has been set. 

The trendline shows that there was a brief timeframe where the goal of 10 days was not being met, which can be attributed to employee turnover and training. Since early 2022, the trendline has significantly dropped due to innovative procedures. As a result of the drop, we have adjusted our goal from 10 days to 5 days starting in July of 2023.

Narrative last updated 03/25/2024

• Nursing Home Providers
• DVHA signatories
• Department of Aging and Independent Living (DAIL)
• Department of Mental Health (DMH)
• Department of Corrections (DOC)

To better serve our clients, we have instituted new templates which cut the time it takes to create a memo down drastically. Additionally, we have implemented a new order of operations to streamline the payment of the rate to the clients. Working with our partner departments, we established a clear path for the rate memo to flow and avoid any missed communication between the three parties involved in processing the rate: DRS, the DVHA Long Term Care Unit, and Gainwell.