March 6, 2024
Greetings!

Today, House and Senate budget writers released their concurrence supplemental operating budget for July 1, 2024, through June 30, 2025. Session will adjourn tomorrow. We have worked all session to elevate the need to improve funding for Medicaid care for assisted living clients; we have also worked with great intent to support SSB 5802, legislation to permit orderly implementation of the Patient Driven Payment Model (PDPM) for skilled nursing facilities.  

Because many of you made it a priority to weigh in with legislators on these important measures, we have positive gains to report. Your advocacy efforts have been critical, and we are truly grateful for the strong and united front. Click here for the budget comparison that details the proposals.  
Assisted Living – Supplemental Budget Hits Three Important Notes 

For assisted living providers serving Medicaid clients, there is additional relief in the supplemental budget: 

  • Base Medicaid payment rates are increased by 2.5 percent, bringing reimbursement for labor costs from 78 to 82 percent of the rates costs.  
  • Specialized Dementia Care daily rate add-on is increased from $43.48 to $50 per resident day. 
  • One-time bridge funding for high-Medicaid census facilities is expanded to provide a $20.99 add on for those providers serving a Medicaid resident census of more than 75 percent. 

While we haven’t lost perspective that assisted living Medicaid rates need to be fully funded, we are grateful for the continued effort to fully implement the rates methodology adopted in 2018. We are thankful that funding for the July 1, 2024 rates rebase is also continued in the supplemental plan.  
Patient Driven Payment Model (PDPM) Legislation is Tied to Conference Budget Funding and Moves Forward to Governor’s Office for Signature  

For skilled nursing facilities, yesterday’s passage of SSB 5802 is good news. The legislation authorizes a transition to the current federal data source which will be used to determine patient acuity scores to calculate Medicaid payments. The use of PDPM data will be phased-in according to funding made available for that purpose. The conference budget allocates $7.7 million to support the initial implementation beginning July 1, 2024. From here, WHCA will work with DSHS on casting July 1, 2024 rates using PDPM data. This is a first step, and we will be focused on a conservative transition that will not bring harm to providers. The bill as passed the legislature includes amendments made by the House which require detailed stakeholder engagement to develop a phase-in plan. We appreciate the staged approach to implementation as necessary for mitigating significant rate swings. 

The funding provided in the underlying budget for an annual rate rebase remains untouched in the Conference Budget.  
We will follow up with a more comprehensive review of this session in the coming days and want to thank you for your efforts to advance our priorities for this session.