Medicaid Reimbursement Per Diem Rates for Non ...

000141800-2010/07

Florida Agency for Health Care Administration

State of Florida Office of Medicaid Cost Reimbursement Planning and Analysis 2727 Mahan Drive-Mail Stop 21 Tallahassee, Florida 32308

Medicaid Reimbursement Per Diem Rates for Non-Institutional Providers

HCR Manor Care Services of Florida, Inc. Heartland Home Health Care and Hospice 8130 Baymeadows Way W Suite Jacksonville, FL 32256

Provider Number: Date:

Fiscal Year End: Audit Status:

000141800

07/02/2010 NIA NIA

Provider Type:

~

..

Current Rate New Rate Effective Date

Rural Health Clinic

I

Swing-Bed Provider

Federally Qualified Health Centers

I

X Hospice Provider

.-

#651 Routine Home Care

#652 Continuous Home Care

?

#655 Inpatient Respite Care

#656 General Inpatient Care

I

#659 Room and Board

$186.42

$187.87 07/0112010 I

..

Basis:

I IRate Type:

- - - Budget - - - Unaudited costs

- - - Desk audited costs - - - Field audited costs

Medicare - Prospective Payment System Rate

-':";""""

X Average Nursing Home Rate

- -X- - Prospective Total Prospective Prospective Adjusted for New Costs

- - - Interim Total Interim Settlement based on costs

Distribution:

Fiscal Agent Contract Management Permanent File Program Development:

W. Rydell Samuel, Administrato

Medicaid Cost Reimbursement Analys'

For information Only (No Change in rate)

V4.032

Report Calculated: 7121201 0 12:28:55PM Report Printed: 7/2/2010

000532400-2010/07

Florida Agency for Health Care Administration

State of Florida Office of Medicaid Cost Reimbursement Planning and Analysis 2727 Mahan Drive-Mail Stop 21 Tallahassee, Florida 32308

Medicaid Reimbursement Per Diem Rates for Non-Institutional Providers

Samaritan Care Hospice of Osceola, LLC Samaritan Care Hospice 1300 North Semoran Blvd., Ste 210 Orlando, FL 32807

Provider Number: Date:

Fiscal Year End: Audit Status:

000532400 07/02/2010

NIA NIA

I Provider Type:

I

Rural Health Clinic

!

Swing-Bed Provider

- - I

~' ......

Federally Qualified Health Centers

X Hospice Provider

i

#651 Routine Home Care

L i

#652 Continuous Home Care

#655 Inpatient Respite Care ....

#656 Generallnp.tient Care

_ ......

#659 Room and Board

......

.

I Current Rate New Rate Effective Date i

I

$191.05 $193.80 07/0112010

- - - Budget - - - Unaudited costs

- - - Desk audited costs - - - Field audited costs

Medicare - Prospective

-

=X -

APvaeyrmageentNSuyrsstienmg

Rate

Home

Rate

Rate Type:

- -X- - Prospective Total Prospective Prospective Adjusted for New Costs

- - - Interim

Total Interim Settlement based on costs

Distribution:

Fiscal Agent Contract Management Permanent File Program Development:

For information Only (No Change in rate)

Medicaid Cost Reimbursement Analys'

V4.032

Report Calculated: 7/2/2010 12:28:55PM Report Printed: 7/2/2010

000602600-2010/07

Florida Agency for Health Care Administration

State of Florida Office of Medicaid Cost Reimbursement Planning and Analysis 2727 Mahan Drive-Mail Stop 21 Tallahassee, Florida 32308

Medicaid Reimbursement Per Diem Rates for Non-Institutional Providers

Vitas Healthcare Corp of Central Florida Attn: Angela Santana 100 S. Biscayne Blvd Suite 1400 Miami, FL 33131

Provider Number: Date:

Fiscal Year End: Audit Status:

000602600 07/02/2010

NIA NIA

L!iovider Type:

~ Rural Health Clinic

Swing-Bed Provider

~FederallY Qualified Health Centers

X Hospice Provider

!

#651 Routine Home Care

!

L

#652 Continuous Home Care

#655 Inpatient Respite Care

1

I

#656 General Inpatient Care

I

#659 Room and Board

i Current Rate New Rate Effective Date

i

I

, .

i

I

$193.12 1 $195.61 I 07/0112010 i

Basis:

--

-- -- --

Budget Unaudited costs Desk audited costs Field audited costs Medicare - Prospective

Payment System Rate -~ X -Average Nursing Home Rate

I I Rate Type:

- -x-

Prospective Total Prospective Prospective Adjusted for New Costs

--

Interim Total Interim Settlement based on costs

Distribution:

Fiscal Agent Contract Management Pennanent File Program Development:

W. Rydell Samuel, Administrato

Medicaid Cost Reimbursement Analys'

For infonnation Only (No Change in rate)

V4.032

Report Calculated: 7/212010 12:28:55PM Report Printed: 71212010

001572800-2010/07

Florida Agency for Health Care Administration

State of Florida Office of Medicaid Cost Reimbursement Planning and Analysis 2727 Mahan Drive-Mail Stop 21 Tallahassee, Florida 32308

Medicaid Reimbursement Per Diem Rates for Non-Institutional Providers

Odyssey Health Care Miami-Dade

5755 Blue Lagoon Dr Suite 170 Miami, FL 33126

I Provider Type:

- _ .Rural Health Clinic

I

Swing-Bed Provider

Federally Qualified Health Centers

. - ..

Provider Number: Date:

Fiscal Year End: Audit Status:

001572800 07/0212010

NIA NIA

Current Rate New Rate Effective Date

i

i

X Hospice Provider

#65l Routine Home Care

i

#652 Continuous Home Care

I

#655 Inpatient Respite Care

i

i

~ ...

#656 General lpatient Care

i

#659 Room and Board

l

$l94.6l $l99.07 07/0lI2010

- - - Budget - - - Unaudited costs - - - Desk audited costs

- - Field audited costs Medicare - Prospective

...."vrn..,nT System Rate

-:;-;--

Nursing Home Rate

I I Rate Type :

- -x- - Prospective Total Prospective Prospective Adjusted for New Costs

- - - Interim Total Interim Settlement based on costs

Distribution:

Fiscal Agent Contract Management Permanent File Program Development:

For information Only (No Change in rate)

Medicaid Cost Reimbursement Analys'

V4.032

Report Calculated: 7/212010 12:28:55PM Report Printed: 712/2010

001636100-2010/07

Florida Agency for Health Care Administration

State of Florida Office of Medicaid Cost Reimbursement Planning and Analysis 2727 Mahan Drive-Mail Stop 21 Tallahassee, Florida 32308

Medicaid Reimbursement Per Diem Rates for Non-Institutional Providers

Regency Hospice ofNW Florida, Inc.

4900 Bayou Blvd., Ste 101 Pensacola, FL 32503

Provider Number: Date:

Fiscal Year End: Audit Status:

001636100 07/02/2010

NIA NIA

PrOVl?der Type: Rural Health Clinic Swing-Bed Provider

-_.

- - ...

..

'Current Rate I New Rate I Eff,ective Date I

!

Federally Qualified Health Centers

X Hospice Provider

~

#651 Routine Home Care

.-

#652 Continuous Home Care

#655 Inpatient Respite Care

i

i

i

I

#656 General Inpatient Care

#659 Room and Board

County: Escambia I ... ... ... -~-~-

--~-~-

I

$190.8...2-~.- .$1- 93... - 94~ i

07/0112010 .. -~-

Basis:

- - Budget

- - Unaudited costs

- - Desk audited costs

- - Field audited costs Medicare - Prospective X Payment System Rate Average Nursing Home Rate

- - - x Prospective Total Prospective Prospective Adjusted for New Costs

- - Interim Total Interim Settlement based on costs

Distribution:

Fiscal Agent Contract Management Permanent File Program Development

W. Rydell Samuel, Administrato

Medicaid Cost Reimbursement Analys?

For information Only (No Change in rate)

V4.032

Report Calculated: 712/2010 12:29:32PM Report Printed: 7/212010

087000500-2010/07

Florida Agency for Health Care Administration

State of Florida Office of Medicaid Cost Reimbursement Planning and Analysis 2727 Mahan Drive-Mail Stop 21 Tallahassee, Florida 32308

Medicaid Reimbursement Per Diem Rates for Non-Institutional Providers

Hospice ofLR.C.

1111 36th Street Vero Beach, FL 32960

Provider Number: Date:

Fiscal Year End: Audit Status:

087000500 07/02/2010

NIA NIA

Provider Type:

i

Rural Health Clinic

Swing-Bed Provider

i

!

Federally Qualified Health Centers

I X Hospice Provider

. #651 Routine Home Care

#652 Contmuous Home Care

#655 Inpatient Respite Care

#656 General Inpatient Care

Board

Current Rate New Rate Effective Date

i

i

$190.44 $195.63 07/0112010

Basis:

- - - Budget

- - - Unaudited costs

- - - Desk audited costs - - - Field audited costs

Medicare - Prospective Payment System Rate

-;-,--

I I Rate Type :

- -x- - Prospective Total Prospective Prospective Adjusted for New Costs

Total Interim Settlement based on costs

Distribution:

Fiscal Agent Contract Management Permanent File Program Development:

w. Rydell Samuel, Administrato

Medicaid Cost Reimbursement Analys'

For information Only (No Change in rate)

V4,032

Report Calculated: 7/2/2010 12:28:55PM Report Printed: 7/2/2010

087246600-2010/07

Florida Agency for Health Care Administration

State of Florida Office of Medicaid Cost Reimbursement Planning and Analysis 2727 Mahan Drive-Mail Stop 21 Tallahassee, Florida 32308

Medicaid Reimbursement Per Diem Rates for Non-Institutioual Providers

Vitas Healthcare Corporation - Dade County Attn: Angela Santana 100 S. Biscayne Blvd Suite 1400 Miami, FL 33131

Provider Number: Date:

Fiscal Year End: Audit Status:

087246600 07/0212010

N/A N/A

Provider Type:

i

! Current Rate New Rate i Effective Date!

Rural Health Clinic

Swing-Bed Provider

I

Federally Qualified Health Centers

i

i

X Hospice Provider

i

#651 Routine Home Care

i

I

#652 Continuous Home Care

i

#655 Inpatient Respite Care

I

i

#656 General Inpatient Care

i

I

#659 Room and Board

_ _ ....

..

$201.63 .. $203.80 I 07/01120iQj

- - - Unaudited costs

- - - Desk audited costs

- - - Field audited costs Medicare - Prospective

-

=X-

-

APvaeyrmageentNSuyrsstienmg

Rate Home

Rate

I I Rate Type:

- - - - x Prospective Total Prospective Prospective Adjusted for New Costs

Tota] Interim Settlement based on costs

Distribution:

Fiscal Agent Contract Management Permanent File Program Development:

W. Rydell Samuel, Administrato

Medicaid Cost Reimbursement Analys'

For information Only ( No Change in rate)

V4.032

Report Calculated: 7/2/2010 12:28:55PM Report Printed: 7/2/2010

087255500-2010/07

Florida Agency for Health Care Administration

State of Florida Office of Medicaid Cost Reimbursement Planning and Analysis 2727 Mahan Drive-Mail Stop 21 Tallahassee, Florida 32308

Medicaid Reimbursement Per Diem Rates for Non-Institutional Providers

St. Francis Hospice

1250-B Grumman Place Titusville, FL 32780 Provider Type:

Provider Number: Date:

Fiscal Year End: Audit Status:

087255500 07/02/2010

NIA NIA

_ _ ......

...._ - -....

Current Rate New Rate I Effective Date

Rural Health Clinic

i

Swing-Bed Provider

i

I

Federally Qualified Health Centers

X Hospice Provider

i

#651 Routine Home Care

I

#652 Continuous Home Care

!

#655 Inpatient Respite Care

General Inpatient Care

i

i

:

Room and Board

$184.39 $192.57 07/01/2010 !

Basis:

- - - Budget

- - - Unaudited costs

- - - Desk audited costs - - - Field audited costs

Medicare - Prospective

-

=X -

APvaeyrmageentNSuyrsstienmg

Rate Home

Rate

I I Rate Type:

- -X- - Prospective Total Prospective Prospective Adjusted for New Costs

Interim

Distribution:

Fiscal Agent Contract Management Permanent File Program Development:

For information Only (No Change in rate)

W. Rydell Samuel, Administrato

Medicaid Cost Reimbursement Analys'

V4.032

Report Calculated: 7/2/2010 12:28:55PM Report Printed: 7/2/2010

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