Supplemental Ventilator Care
and Tracheostomy Care Payments
Supplemental Ventilator Care Payments
Supplemental ventilator care payments (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:
- The facility has a minimum of ten MA-recipient residents who receive medically necessary ventilator care.
- 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 (percentage of MA ventilator care residents x $69 x percentage 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 & 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|