{"data":{"id":"us-va/12vac30-90-310","jurisdiction":"us-va","citation":"12VAC30-90-310","heading":"Normalized Case Mix Index (NCMI)","body":"Appendix V\n\nNormalized Case Mix Index\n\nA. This appendix illustrates how a specialized care provider's Normalized Case Mix Index (NCMI) is used to adjust the prospective routine operating cost base rate and prospective operating ceiling.\n\nB. Assumptions.\n\n1. The nursing facility's fiscal years are December 31, 1996, and December 31, 1997.\n\n2. The average allowable routine nursing labor and nonlabor base rate for December 31, 1996, is $205.\n\n3. The average allowable indirect patient care operating base rate for December 31, 1996, is $90.\n\n4. The allowance for inflation is 3.0% for the fiscal year end beginning January 1, 1997.\n\n5. The nursing facility's statewide ceiling for the fiscal year end beginning January 1, 1997, is $300.\n\n6. The nursing facility's normalized HCFA nursing wage index is 1.0941 for the fiscal year end beginning January 1, 1997.\n\n7. The nursing facility's semiannual normalized NCMIs are as follows:\n\n1996 First semiannual NCMI\n\n1.2000\n\n1996 Second semiannual NCMI\n\n1.2400\n\n1997 First semiannual NCMI\n\n1.2600\n\nC. Calculation of nursing facility's operating ceiling.\n\n1. Period January 1, 1997, through June 30, 1997.\n\nFYE 1997 Statewide Ceiling\n\n$300\n\nNursing Labor Component Percentage\n\nx 67.22%\n\n= $201.66\n\nNormalized Wage Index\n\nx 1.0941\n\nAdjusted Nursing Labor Ceiling Component\n\n= $220.64\n\nNursing Nonlabor Ceiling Component\n\n+ $11.49\n\nAdjusted Nursing Labor and Nonlabor Ceiling\n\n= $232.13\n\nFYE 1996 Second semiannual NCMI\n\nx 1.2400\n\n= $287.84\n\nIndirect Patient Care Ceiling Component\n\n($300.00\n\n- 201.66\n\n- 11.49)\n\n= $86.85\n\nTotal Facility Operating Ceiling\n\n$287.84\n\n= $374.69\n\n2. Period July 1, 1997, through December 31, 1997.\n\nAdjusted Nursing Labor and Nonlabor Ceiling per subdivision   1 of this subsection\n\n$232.13\n\nFYE 1997 First semiannual NCMI\n\nx 1.2600\n\n= $292.48\n\nIndirect Patient Care Ceiling Component\n\n+ 86.85\n\nTotal Facility Operating Ceiling\n\n= $379.33\n\nD. Calculation of nursing facility's prospective operating cost rate.\n\n1. Prospective operating cost base rate.\n\nFYE 1996 Nursing Labor and Nonlabor Operating Base Rate\n\n$205\n\nAllowance for Inflation - FYE 1997\n\nx 1.03\n\nProspective Nursing Labor and Nonlabor Cost Rate\n\n= $211.15\n\nFYE 1996 Indirect Patient Care Operating Base Rate\n\n$90.00\n\nAllowance for Inflation - FYE 1997\n\nx 1.03\n\nProspective Indirect Patient Care Operating Cost Rate\n\n= $92.70\n\n2. Calculation of FYE 1996 Average NCMI.\n\nFirst semiannual Period NCMI\n\n1.2000\n\nSecond semiannual Period NCMI\n\n1.2400\n\nAverage FYE 1996 NCMI\n\n1.2200\n\n3. Calculation of FYE 1997 NCMI Rate Adjustments.\n\na. Rate adjustment for the period January 1, 1997, through June 30, 1997.\n\n1996 Second semiannual NCMI\n\n1.2400\n\n1996 Average NCMI (from subdivision 2 of this subsection\n\n1.2200\n\nCalculation:\n\n1.2400/1.2200\n\nRate Adjustment Factor\n\n= 1.0164\n\nProspective Nursing Labor and Nonlabor Operating Cost Base   Rate (from subdivision 1 of this subsection)\n\n$211.15\n\nx 1.0164\n\n= $214.61\n\nProspective Indirect Patient Care Operating Cost Rate (from   subdivision 1 of this subsection)\n\n+ $92.70\n\nTotal Prospective Operating Cost Rate\n\n= $307.31\n\nb. Rate Adjustment for the Period July 1, 1997, through December 31, 1997.\n\n1997 First semiannual NCMI\n\n1.2600\n\n1996 Average NCMI (from subdivision 2 of this subsection)\n\n1.2200\n\nCalculation:\n\n1.2600/1.2200\n\nRate Adjustment Factor\n\n= 1.0328\n\nProspective Nursing Labor and Nonlabor Operating Cost Rate   (from subdivision 1 of this subsection)\n\n$211.15\n\nRate Adjustment Factor\n\nx 1.0328\n\nProspective Indirect Patient Care Operating Cost Rate (from   subdivision 1 of this subsection)\n\n$ 92.70\n\nTotal Prospective Operating Cost Rate\n\n= $310.78\n\nD. In this illustration the nursing facility's operating reimbursement rate for FYE 1997 would be as follows:\n\n1. For the period January 1, 1997, through June 30, 1997, the operating reimbursement rate would be $307.31 since the prospective operating cost rate is lower than the nursing facility's NCMI adjusted ceiling of $374.69 (from subdivision C 1 of this section).\n\n2. For the period July 1, 1997, through December 31, 1997, the operating reimbursement rate would be $310.78 since the prospective operating cost rate is lower than the nursing facility's NCMI adjusted ceiling of $379.33 (from subdivision C 2 of this section).","path":["Title 12. Health","Agency 30. Department of Medical Assistance Services","Chapter 90. Methods and Standards for Establishing Payment Rates for Long-Term Care","Part III. Nursing Home Payment System Appendices Appendix I Uniform Expense Classification","Article 2. Capital Cost Applicable"],"source_url":"https://law.lis.virginia.gov/admincode/title12/agency30/chapter90/section310/","current_through":"2026 Regular Session (effective July 1, 2026)","vintage":"","retrieved_at":"2026-09-14T04:51:02Z","sha256":"ef18d7f661542cfc3b06adf8c16a7098c28dc537beb1bc9f9d704a324cbf60e6","source_id":"us-va-vac","stale":false,"prev":"us-va/12vac30-90-307","next":"us-va/12vac30-90-320"},"notice":"GroundRules: Original legal text. Not legal advice."}