MI/DD population Services Rule? Is it (>=25%) or 2) anticipated that the very high Medicaid subject facility and/or the Census (>=80%) subject facility type will be compliant with the state’s plan? Is the long term viability of the Medicaid Waiver Program at risk for such facilities? Does the subject facility exhibit the ability to operate without Medicaid Waiver residents? Medicaid Projects with SNF Does the project Reimbursement beds in states with demonstrate the ability to Delays a pattern of handle delayed payments extensive without AR Financing? reimbursement delays without AR Financing Budgetary Projects with SNF Does the owner/operator Constraints beds that have have a plan for working Medicaid Census through rate reductions, of 80% or more, rate freezes or changes in or whose DSCR eligibility? Does the falls below 1.0 facility demonstrate an with a decline of ability to remain viable, as 5% or less in evidenced by a Sensitivity Medicaid Census Analysis showing how or Rate income, expenses and NOI would be impacted by the above changes? Money Follows the Concentration of If MI/DD residents are Person (MI/DD) MI/DD population predominantly non-elderly, (>=25%) in how might the facility be either: 1) Board & impacted by MFP, Care, 2) SNF/ALF Balancing Incentives combos, or 3) Program and other state combo including efforts? Are “rebalancing” B&C beds; there any constraints on projects with ICF facility’s ability to serve beds other types of residents in these beds/units? Is State
MI/DD population (>=25%) or 2) very high Medicaid Census (>=80%) Services Rule? Is it anticipated that the subject facility and/or the subject facility type will be compliant with the state’s plan? Is the long term viability of the Medicaid Waiver Program at risk for such facilities? Does the subject facility exhibit the ability to operate without Medicaid Waiver residents? Medicaid Reimbursement Delays Projects with SNF beds in states with a pattern of extensive reimbursement delays without AR Financing Does the project demonstrate the ability to handle delayed payments without AR Financing? Budgetary Constraints Projects with SNF beds that have Medicaid Census of 80% or more, or whose DSCR falls below 1.0 with a decline of 5% or less in Medicaid Census or Rate Does the owner/operator have a plan for working through rate reductions, rate freezes or changes in eligibility? Does the facility demonstrate an ability to remain viable, as evidenced by a Sensitivity Analysis showing how income, expenses and NOI would be impacted by the above changes? Money Follows the Person (MI/DD) Concentration of MI/DD population (>=25%) in either: 1) Board & Care, 2) SNF/ALF combos, or 3) combo including B&C beds; projects with ICF beds If MI/DD residents are predominantly non-elderly, how might the facility be impacted by MFP, Balancing Incentives Program and other state “rebalancing” efforts? Are there any constraints on facility’s ability to serve other types of residents in these beds/units? Is State
SEPTEMAILBLAST09232015.DOCX