DAL - Dear Administrator Letter

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April 23, 2025

Dear Administrator,

This letter provides you with updated information regarding the implementation of the 2023 Nursing Home Quality Pool (NHQP) and replaces the letter previously sent on April 22, 2025.

The NHQP is an annual budget-neutral pool that was established in accordance with section 2802(2- c)(d) of the Public Health Law. The amount of the pool is $50 million, and it was created to incentivize nursing homes across New York State to improve the quality of care for their residents and to reward homes for quality based on their performance. As a reminder, the methodology for administering the quality pool is attached.

Due to a systems issue, the processing of the 2023 NHQP liabilities and payments will occur in different cycles. The processing of the liabilities will take effect in cycle 2487, with a check release date of May 7, 2025. The processing of the payments will take effect in cycle 2488 with a check release date of May 14, 2025. Please note that if your facility is receiving a payment, then any existing balance due to the Department will be recouped from this payment and applied to the balance. You will only receive payment for the amount that exceeds the liability balance.

If you have any questions regarding these payments and liabilities, please email bimamail@health.ny.gov. For questions regarding the calculation of the NHQP, please email NFRates@health.ny.gov.

Sincerely,

Laura Rosenthal
Director
Bureau of Nursing Home and Long-Term Care Rate Setting
Division of Finance and Rate Setting
Office of Health Insurance Programs

Attachment

ATTACHMENT A
Nursing Home Quality Pool Award 2023

  • Each nursing home was ranked into 5 quintiles by utilizing the methodology as set forth by the State. The methodology and individual nursing home quintile rankings can be found on this link: Nursing Home Quality Initiative.
  • To fund the $50 million pool, EVERY nursing home’s contribution is calculated as follows:
    •     Calendar Year Promulgated Rate x MA Days                            x $50,000,000
    •             Statewide NH Total MA Revenue
  • Only facilities who are ranked in quintiles 1, 2 or 3 will receive a share of the $50 million NHQP. The distribution method is as follows:
    • Award Amounts:
      • Quintile 1: MA Revenue x 3
      • Quintile 2: MA Revenue x 2.25
      • Quintile 3: MA Revenue x 1.5
    • Share of the $50 million award:
      •     Quintile 1, 2, or 3 Award Amount                            x $50,000,000
      •           Total of Statewide Awards
  • Facilities who receive a J/K/L Health Inspection Deficiency receive no award, regardless of their Quintile scoring.

For the summary and calculation of the NHQP for 2023, please refer to: https://www.health.ny.gov/facilities/long_term_care/reimbursement/nhr/