| (1) Proprietary facilities. The allowable appraised
values of proprietary facilities to be reported on Texas Medicaid
cost reports are determined from local property taxing authority appraisals.
The year of the property appraisal must be the calendar year within
which the provider's cost report fiscal year ends, or the prior calendar
year.
(2) Tax exempt facilities. The allowable appraised
property values for tax exempt facilities are determined as follows.
(A) Tax exempt facilities provided an appraisal from
their local property taxing authority. Tax exempt facilities provided
an appraisal from their local property taxing authority must report
this appraised value on their Texas Medicaid cost report. The year
of the property appraisal must be the calendar year within which the
provider's cost report fiscal year ends, or the prior calendar year.
(B) Tax exempt facilities not provided an appraisal
from their local property taxing authority. Tax exempt facilities
not provided an appraisal from their local property taxing authority
because of an "exempt" status must provide documentation
received from the local taxing authority certifying exemption for
the current reporting period and must contract with an independent
appraiser to appraise the facility land and improvements. These independent
appraisals must meet the following criteria.
(i) The appraisal must value land and improvements
using the same basis used by the local taxing authority under Texas
laws regarding appraisal methods and procedures.
(ii) The appraisal must be updated every five years
with the initial appraisal setting the five-year interval.
(I) Facilities achieving exempt status during their
fiscal year ending in calendar year 1997 or a subsequent year must
submit an initial appraisal to HHSC's Rate Analysis Department as
part of their cost report for the fiscal year during which the exempt
status was achieved. This appraisal must be reflective of the facility's
appraised value during that fiscal year.
(II) If a facility is reappraised due to improvements
or reconstruction as defined in clause (iii) of this subparagraph,
a new five-year interval will be set.
(iii) Facilities making capital improvements, or requiring
reconstruction due to fire, flood, or other natural disaster, when
the improvements or reconstruction cost more than $2,000 per licensed
bed, may contract with an independent appraiser to have land and improvements
reappraised within the cost reporting period in which the improvement(s)
is placed into service.
(iv) If for any reason an appraisal becomes available
from the local taxing authority for a provider who previously lacked
such an appraisal, the provider must report, on the next Texas Medicaid
cost report submitted, the local taxing authority's appraised values
instead of the independent appraisal values.
(3) Governmental facilities. Governmental facilities
are exempt from the requirement to report an appraised property value.
(h) In addition to the requirements of §355.102
and §355.103 of this title, the following apply to costs for
the nursing facilities (NF) program.
(1) Medical costs. The costs for medical services and
items delineated in 40 TAC §19.2601 (relating to Vendor Payment)
are allowable. These costs must also comply with the general definition
of allowable costs as stated in §355.102 of this title.
(2) Chaplaincy or pastoral services. Expenses for chaplaincy
or pastoral services are allowable costs.
(3) Voucherable costs. Except as detailed in subparagraphs
(A) and (B) of this paragraph, any expenses directly reimbursable
to the provider through a voucher payment and any expenses in excess
of the limit, or ceiling, for a voucher payment system are unallowable
costs.
(A) The ventilator dependent supplemental voucher system
and the children with tracheostomies supplemental voucher system are
not subject to the cost reporting restrictions described in this paragraph.
(B) Select voucher systems, when indicated by department
procedures, are not subject to the cost reporting restrictions described
in this paragraph. To avoid the possibility of providers being reimbursed
through the voucher system and the daily rate for the same expenses,
the department may not waive the cost reporting restrictions described
in this paragraph unless the following criteria are met:
(i) the voucher system is a temporary system;
(ii) the costs represent ongoing costs; and
(iii) the costs are not represented in the payment
rate until after the voucher system has been discontinued.
(4) Preferred items. Costs for preferred items which
are billed to the recipient, responsible party, or the recipient's
family are not allowable costs.
(5) Preadmission Screening and Annual Resident Review
(PASARR) expenses. Any expenses related to the direct delivery of
specialized services and treatment required by PASARR for residents
are unallowable costs.
(6) Advanced Clinical Practitioner (ACP) or Licensed
Professional Counselor (LPC) services. Expenses for services provided
by an ACP or LPC are unallowable costs.
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| Source Note: The provisions of this §355.306 adopted to be effective October 1, 1990, 15 TexReg 5220; amended to be effective May 15, 1991, 16 TexReg 2009; amended to be effective September 1, 1996, 21 TexReg 7861; transferred effective September 1, 1997, as published in the Texas Register October 17, 1997, 22 TexReg 10311; amended to be effective May 1, 2000, 25 TexReg 3517; amended to be effective July 23, 2002, 27 TexReg 6501; amended to be effective January 9, 2005, 29 TexReg 12121; amended to be effective December 14, 2010, 35 TexReg 10944; amended to be effective September 1, 2011, 36 TexReg 4652; amended to be effectiveNovember 25, 2012, 37 TexReg 9086; amended to be effective January 1, 2019, 43 TexReg 8581 |
