Nursing Home Providers

  • Covers institutional care for recipients who are unable to remain at home or in the community.
  • The quality of nursing home care is regulated by Healthcare Facility Regulation, a division of the Georgia Department of Community Health.
  • Reimbursement Rates: Per diem rates are calculated from standardized cost reports. Allowable costs are determined using department policy, federal principles of reimbursement and audits of cost reports. Effective July 1, 2022, the 2020 cost reports are used to compute reimbursement rates.

If your facility has received certifications from Joint Commission or the American Health Care Association (AHCA), please see chart below to determine the total Quality Incentive percentage applicable for your facility.

Total Quality Incentive Percentage
Nursing Hours MyInnerView (Inclusive of AHCA Bronze Accreditation) AHCA Silver Accreditation AHCA Gold Accreditation Joint Commission Accreditation Total Quality
(Max 1%) (Max 2%) (Max 1%) (Max 2%) (Max 2%)  
1% 1%       2%
1% 1% 1%     3%
1% 1%   2%   4%
1% 1%     2% 4%
1% 1% 1%   2% 5%
1% 1%   2% 2% 6%
1% 2%       3%
1% 2% 1%     4%
1% 2%   2%   5%
1% 2%     2% 5%
1% 2% 1%   2% 6%
1% 2%   2% 2% 7%


Reimbursement rates are calculated quarterly (July 1, October 1, January 1, and April 1). The Reimbursement rates for FYE June 30, 2023, are located below.

January 1, 2023 (0% Growth, Quality Incentive and audited 2020 GL/PL Insurance Costs)

Please note that the reimbursement rate sheets (R-32) are in numerical order.  The rate sheets can also be found using the “Search or Find” feature on your PDF reader.

October 1, 2022 (0% Growth, Quality Incentive and audited 2020 GL/PL Insurance Costs)

Please note that the reimbursement rate sheets (R-32) are in numerical order.  The rate sheets can also be found using the “Search or Find” feature on your PDF reader.

July 1, 2022 (0% Growth, Quality Incentive and audited 2020 GL/PL Insurance Costs)

Please note that the reimbursement rate sheets (R-32) are in numerical order.  The rate sheets can also be found using the “Search or Find” feature on your PDF reader.

 

The Department of Community Heath received approval from the Center of Medicare and Medicaid Services (CMS) for its Public Health Emergency policy change and reimbursement for nursing facility services. The Department will use the audited 2019 Medicaid cost report with audited 2021 Medicaid cost report data for GLPL, RS Means and Taxes & Insurance to calculate the nursing home rate effective July 1, 2021 through June 30, 2022. Included in the rate calculation is a five (5%) percent growth allowance inflation factor and a hold harmless provision for the first year of the rate calculation.  

 

The initial FY 2022 rate sheets are located on the archive page.

Please note that you will still have to access the Myers & Stauffer Web Portal (https://myersandstauffer.com/client-portal/georgia/) in order to download the Preliminary and Final Listing of Resident file.

Contact Senior Manager

Angelica Clark Hester

[email protected]

Contact Director of Reimbursement

Kim Morris

[email protected]