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 Health 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, 2014, the 2012 cost reports are used to compute reimbursement rates.


Reimbursement rates are calculated quarterly (July 1, October 1, January 1, and April 1). The Reimbursement rates for FYE June 30, 2022, are located below.

July 1, 2021 (13.37% Growth, Quality Incentive and audited 2018 GL/PL Insurance Costs)

Please note that the reimbursement rate sheets (R-32) are in alphabetical order. Please locate the PDF file where the Provider's Name would fall. Open the PDF and scroll down to the Provider R-32 you need and print.

The Department of Community Heath received approval from the Center of Medicare and Medicaid Services (CMS) for a temporary 5% growth increase effective July 1, 2020 through June 30, 2021 for all nursing home providers. The Department also received approval for quality incentives related to the Joint Commission and American Health Care Association (AHCA) Accreditation effective August 14, 2020.  Reimbursement rates have been recalculated effective July 1, 2020 through June 30, 2021. Please see the revised rate sheets below.

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%)  
1% 1%     2%
1% 2%     3%
1% 1% 1%   3%
1% 2% 1%   4%
1% 1%   2% 4%
1% 2%   2% 5%

 

The Reimbursement rates for FYE June 30, 2021, are located below.

April 1, 2021 (revised rates inclusive of 18.37% Growth and Quality Incentive)

Please note that the reimbursement rate sheets (R-32) are in alphabetical order.  Please locate the pdf file where the Provider's Name would fall.  Open the pdf and scroll down to the Provider R-32 you need and print.

Initial rate sheets for April 1, 2021 are located on the archive page.

 

January 1, 2021 (revised rates inclusive of 18.37% Growth and Quality Incentive)

Please note that the reimbursement rate sheets (R-32) are in alphabetical order.  Please locate the pdf file where the Provider's Name would fall.  Open the pdf and scroll down to the Provider R-32 you need and print.

Initial rate sheets for January 1, 2021 are located on the archive page.

 

October 1, 2020 (revised rates inclusive of 18.37% Growth and Quality Incentive)

Please note that the reimbursement rate sheets (R-32) are in alphabetical order.  Please locate the pdf file where the Provider's Name would fall.  Open the pdf and scroll down to the Provider R-32 you need and print.

Initial rate sheets for October 1, 2020 are located on the archive page.

 

August 14, 2020 (revised rates inclusive of 18.37% Growth and Quality Incentive)

Please note that the reimbursement rate sheets (R-32) are in alphabetical order.  Please locate the pdf file where the Provider's Name would fall.  Open the pdf and scroll down to the Provider R-32 you need and print.

 

July 1, 2020 (revised rates inclusive of 18.37% Growth)

Please note that the reimbursement rate sheets (R-32) are in alphabetical order.  Please locate the pdf file where the Provider's Name would fall.  Open the pdf and scroll down to the Provider R-32 you need and print.

Initial rate sheets for July 1, 2020 are located on the archive page.

 

The Reimbursement rates for FYE June 30, 2020, are located on the archive page.

 

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