Supplemental Ventilator Care Payments

Supplemental SVCP payments will be made to qualifying MA nonpublic and county nursing facilities each quarter effective July 1, 2012 based on the following:                                                                                                                                                                                                          A nonpublic and county nursing facility will qualify for the SVCP if both of the following criteria are met based on each Picture Date:                                                                                                                                                                                                              (A) The facility has a minimum of ten MA-recipient residents who receive medically necessary ventilator care.
(B) The facility has a minimum of 10% of their MA-recipient resident population receiving medically necessary ventilator care calculated as the number of MA ventilator care residents divided by the total number of MA residents listed on the Picture Date CMI Report.
The determination of medically necessary ventilator care is based on whether there is a positive response to MDS 3.0 Section O0100F1 or O0100F2 on the MDS assessment identified on the Picture Date CMI Report.
The SVCP per diem is calculated as (% of MA ventilator care residents x $69 x % of MA ventilator care residents). The quarterly SVCP to qualifying facilities is calculated as the SVCP per diem times the number of paid MA facility and therapeutic leave days for the calendar quarter that contains the Picture Date used to determine the qualifying criteria.                                                                                                                                                                                                             Picture Date                                   Authorization Schedule       Paid Facility and Therapeutic Leave Day Quarter
February 1                                      September                          January 1 - March 31
May 1                                              December                           April 1 - June 30
August 1                                         March                                  July 1 - September 30
November 1                                    June                                    October 1 - December 31

SVCP Payments for December 2013