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Finance director: Rockingham County nursing home sees preliminary $23-per-day Medicaid rate increase
Summary
County finance staff reported a preliminary increase in the Medicaid daily rate for the county nursing home of roughly $23.25, driven by updated acuity capture and MDS coding improvements; staff said the added revenue would flow to unreserved fund balance pending final state action.
Chuck Nickerson, the county finance director, told commissioners on June 4 that Rockingham County’s preliminary Medicaid nursing-home rate for July 1 was significantly higher than earlier budget assumptions.
Nickerson said the county’s tentative Medicaid nursing-home rate moved from about $2,267.94 to $2,291.19 per day — an increase of roughly $23.25 per resident per day. "Rockingham County is anticipating $23.25, tentatively," Nickerson said, adding the increase reflects efforts by the county’s MDS team to capture resident acuity and coding more completely.
Finance staff and long-term care leaders told commissioners they had budgeted conservatively for a 3% reduction based on earlier guidance; Nickerson said the preliminary number means the county will not lose as much Medicaid revenue as feared. He said any extra revenue from the higher rate would flow into the county’s unreserved fund balance because the budget cannot be updated midyear. "So that extra revenue is gonna go into the unreserved balance at the end of the year," Nickerson said.
Long-term care staff credited MDS and documentation work for the change. A senior long-term care staff member who identified herself as JJ said the team had been revamping documentation and coding to align with updated guidance and better capture acuity. County leaders noted that some other counties face negative adjustments or potential proshare reconciliation obligations; Nickerson said there is ongoing state and federal uncertainty but that Rockingham’s preliminary result was favorable.
County officials cautioned the figure is preliminary and subject to final state and legislative actions. Nickerson told the board the Senate’s version of budget adjustments and potential appeals on related matters had not completed committee conference and that the county would monitor for changes. He said staff will incorporate the final rate into year-end calculations and return updates to the board.
