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  • Healthcare-associated Infections (HAI) Surcharge, Medical Assistance (MA) Pass-through Payments

    (for MA-11 Cost Reports with Acceptance Letters mailed on or before August 4, 2017)

    The Department of Healths annual health-care associated infection (HAI) surcharge on a nursing facilitys licensing fee is an allowable cost under the MA Program. The MA portion of the HAI surcharge will be reimbursed as a pass-through payment and will be paid on an annual basis. A nursing facilitys annual HAI pass-through payment will equal the annual HAI surcharge fee paid by the nursing facility, less any penalties assessed, as verified by the DOH, multiplied by the nursing facilitys MA occupancy rate as reported on the nursing facilitys MA-11 cost report for the year in which the annual HAI surcharge is paid. The HAI pass-through payment will be made annually within 120 days after the submission of an acceptable cost report provided that payment will not be made before the later of 210 days from the close of the nursing facility fiscal year or the date on which the DOH received payment of the nursing facilitys HAI surcharge fee.

    HAI Surcharge, MA Pass-through Payments (for the MA-11 cost reports with acceptance letters mailed on or before August 4, 2017):

    Cost

    Current Name HAI

    Surcharge

    Report Begin Date

    Cost Report

    End Date Acceptance Letter Date

    MA Occupancy

    HAI Payment RA Date

    ALTOONA CENTER FOR NURSING CARE $1,493.16 1/1/2016 12/31/2016 4/13/2017 83.09% $1,240.67 8/28/2017 AMBLER EXTENDED CARE CENTER $1,244.30 1/1/2016 12/31/2016 4/13/2017 79.31% $986.85 8/28/2017 ASBURY HEALTH CENTER $1,729.58 1/1/2016 12/31/2016 7/6/2017 42.03% $726.94 8/28/2017 ATTLEBORO NURSING AND REHAB CENTER $2,227.30 1/1/2016 12/31/2016 5/16/2017 64.83% $1,443.96 8/28/2017 AVALON SPRINGS NURSING CENTER $1,244.30 1/1/2016 12/31/2016 5/8/2017 77.70% $966.82 8/28/2017 BARCLAY FRIENDS $1,194.53 1/1/2016 12/31/2016 6/20/2017 32.35% $386.43 8/28/2017 BEACON RIDGE, A CHOICE COMMUNITY $1,468.27 1/1/2016 12/31/2016 6/28/2017 64.12% $941.45 8/28/2017 BEAVER HEALTHCARE AND REHABILITATION CTR $833.68 1/1/2016 12/31/2016 5/2/2017 70.31% $586.16 8/28/2017 BELLE HAVEN HEALTHCARE & REHAB CENTER $734.14 1/1/2016 12/31/2016 5/4/2017 70.86% $520.21 8/28/2017 BELLE REVE HEALTH CARE CENTER $373.29 1/1/2016 12/31/2016 6/20/2017 36.26% $135.35 8/28/2017 BERKS HEIM NURSING & REHABILITATION $5,226.06 1/1/2016 12/31/2016 6/15/2017 79.11% $4,134.34 8/28/2017 BETHANY VILLAGE RETIREMENT CENTER $858.57 1/1/2016 12/31/2016 5/31/2017 27.84% $239.03 8/28/2017

  • Cost

    Current Name HAI

    Surcharge

    Report Begin Date

    Cost Report

    End Date Acceptance Letter Date

    MA Occupancy

    HAI Payment RA Date

    BETHLEN HM OF THE HUNGARIAN RFRMD FED $1,194.53 1/1/2016 12/31/2016 5/16/2017 56.42% $673.95 8/28/2017 BIRCHWOOD NURSING AND REHAB CENTER $1,505.60 1/1/2016 12/31/2016 5/8/2017 74.39% $1,120.02 8/28/2017 BONHAM NURSING CENTER $958.11 4/5/2016 12/31/2016 5/31/2017 80.60% $772.24 8/28/2017 BRADFORD COUNTY MANOR $2,488.60 1/1/2016 12/31/2016 5/31/2017 76.20% $1,896.31 8/28/2017 BRADFORD ECUMENICAL HOME, INC $1,244.30 1/1/2016 12/31/2016 4/13/2017 62.79% $781.30 8/28/2017 BRADFORD MANOR $1,430.94 1/1/2016 12/31/2016 5/22/2017 71.09% $1,017.26 8/28/2017 BRIGHTON REHABILITATION & WELLNESS CTR $7,328.93 1/1/2016 12/31/2016 5/8/2017 78.49% $5,752.48 8/28/2017 BROAD ACRES HEALTH AND REHAB CENTER $1,493.16 1/1/2016 12/31/2016 3/27/2017 66.19% $988.32 8/28/2017 BROOKLINE MANOR AND REHABILITATIVE SRVCS $1,057.66 1/1/2016 12/31/2016 5/2/2017 57.46% $607.73 8/28/2017 BROOKMONT HEALTHCARE CENTER LLC $1,480.72 1/1/2016 12/31/2016 5/2/2017 65.96% $976.68 8/28/2017 BROOKSIDE HEALTHCARE AND REHAB CENTER $1,493.16 1/1/2016 12/31/2016 5/8/2017 77.56% $1,158.09 8/28/2017 BROOKVIEW HEALTH CARE CENTER $1,891.34 1/1/2016 12/31/2016 7/14/2017 38.24% $723.25 8/28/2017 BROOMALL MANOR $1,530.49 1/1/2016 12/31/2016 4/13/2017 88.55% $1,355.25 8/28/2017 BROOMALL PRESBYTERIAN VILLAGE $1,816.68 1/1/2016 12/31/2016 6/20/2017 62.46% $1,134.70 8/28/2017 BROOMALL REHAB AND NURSING CENTER $3,708.01 1/1/2016 12/31/2016 7/14/2017 74.35% $2,756.91 8/28/2017 BRYN MAWR EXTENDED CARE CENTER $1,990.88 1/1/2016 12/31/2016 4/13/2017 80.26% $1,597.88 8/28/2017 BUFFALO VALLEY LUTHERAN VILLAGE $1,269.19 1/1/2016 12/31/2016 6/20/2017 69.89% $887.04 8/28/2017 CAMBRIA CARE CENTER $3,745.34 1/1/2016 12/31/2016 4/18/2017 85.91% $3,217.62 8/28/2017 CANTERBURY PLACE $1,219.41 1/1/2016 12/31/2016 6/6/2017 59.51% $725.67 8/28/2017 CARBONDALE NURSING AND REHAB CENTER $1,430.94 1/1/2016 12/31/2016 6/28/2017 77.11% $1,103.40 8/28/2017 CARE PAVILION NURSING AND REHAB CENTER $4,927.43 1/1/2016 12/31/2016 5/16/2017 92.20% $4,543.09 8/28/2017 CARING HEIGHTS COMMUNITY CARE & REHAB $1,493.16 1/1/2016 12/31/2016 4/13/2017 77.93% $1,163.62 8/28/2017 CARLETON HEALTHCARE & REHABILITATION CTR $323.52 1/1/2016 12/31/2016 5/2/2017 65.37% $211.49 8/28/2017 CEDAR HAVEN HEALTHCARE CENTER $4,031.53 1/1/2016 12/31/2016 5/22/2017 86.86% $3,501.79 8/28/2017 CEDARBROOK NURSING HOMES $8,336.81 1/1/2016 12/31/2016 5/31/2017 89.78% $7,484.79 8/28/2017 CENTENNIAL HEALTHCARE & REHAB CENTER $2,239.74 1/1/2016 12/31/2016 6/28/2017 80.66% $1,806.57 8/28/2017 CENTRE CREST $2,986.32 1/1/2016 12/31/2016 3/27/2017 76.91% $2,296.78 8/28/2017 CHAMBERS POINTE HEALTH CARE CENTER $746.58 1/1/2016 12/31/2016 7/14/2017 31.11% $232.26 8/28/2017 CHANDLER HALL HEALTH SERVICES INC $659.48 1/1/2016 12/31/2016 7/6/2017 50.76% $334.75 8/28/2017 CHAPEL POINTE AT CARLISLE $734.14 1/1/2016 12/31/2016 5/22/2017 40.97% $300.78 8/28/2017 CHERRY TREE NURSING CENTER $1,493.16 1/1/2016 12/31/2016 5/8/2017 80.89% $1,207.82 8/28/2017 CHESTER VALLEY REHAB AND NURSING CENTER $2,289.51 1/1/2016 12/31/2016 5/8/2017 79.96% $1,830.69 8/28/2017 CHESTNUT HILL LODGE HEALTH AND REHAB CTR $2,252.18 1/1/2016 12/31/2016 6/28/2017 90.02% $2,027.41 8/28/2017 CHURCH OF GOD HOME, INC $1,356.29 1/1/2016 12/31/2016 5/8/2017 41.75% $566.25 8/28/2017 CLAREMONT NRC OF CUMBERLAND COUNTY $3,608.47 1/1/2016 12/31/2016 6/15/2017 72.32% $2,609.65 8/28/2017

  • Cost

    Current Name HAI

    Surcharge

    Report Begin Date

    Cost Report

    End Date Acceptance Letter Date

    MA Occupancy

    HAI Payment RA Date

    CLARION HEALTHCARE AND REHAB CENTER $1,032.77 1/1/2016 9/30/2016 3/27/2017 72.89% $752.79 8/28/2017 CLARVIEW NURSING AND REHAB CENTER $1,493.16 1/1/2016 12/31/2016 3/27/2017 70.69% $1,055.51 8/28/2017 CLEPPER MANOR $671.92 1/1/2016 12/31/2016 5/31/2017 75.07% $504.41 8/28/2017 CLIVEDEN NSG & REHAB CTR $2,239.74 1/1/2016 12/31/2016 5/16/2017 86.85% $1,945.21 8/28/2017 COLONIAL MANOR NURSING HOME $3,359.61 1/1/2016 12/31/2016 5/16/2017 81.93% $2,752.53 8/28/2017 COLONIAL PARK CARE CENTER $2,463.71 1/1/2016 12/31/2016 4/21/2017 75.30% $1,855.17 8/28/2017 COMMUNITIES AT INDIAN HAVEN $1,343.84 1/1/2016 12/31/2016 7/6/2017 57.19% $768.54 8/28/2017 CONCORDIA AT THE CEDARS $734.14 1/1/2016 12/31/2016 5/31/2017 64.12% $470.73 8/28/2017 CONESTOGA VIEW $5,549.58 1/1/2016 12/31/2016 6/15/2017 87.71% $4,867.54 8/28/2017 CONSULATE HEALTH CARE OF CHESWICK $1,505.60 1/1/2016 12/31/2016 6/15/2017 86.22% $1,298.13 8/28/2017 CONSULATE HEALTH CARE OF NORTH STRABANE $771.47 1/1/2016 12/31/2016 6/20/2017 73.99% $570.81 8/28/2017 CORNWALL MANOR $1,194.53 1/1/2016 12/31/2016 7/14/2017 28.99% $346.29 8/28/2017 CORRY MANOR $1,505.60 1/1/2016 12/31/2016 5/22/2017 68.37% $1,029.38 8/28/2017 COUNTRY MEADOWS NURSING CENTER-BETHLEHEM $871.01 1/1/2016 12/31/2016 7/14/2017 3.00% $26.13 8/28/2017 COUNTRYSIDE CHRISTIAN COMMUNITY $410.62 1/1/2016 12/31/2016 6/28/2017 57.82% $237.42 8/28/2017 COURTYARD GARDENS NURSING AND REHAB CTR $1,269.19 1/1/2016 12/31/2016 6/6/2017 56.82% $721.15 8/28/2017 CRAWFORD COUNTY CARE CENTER $1,953.55 1/1/2016 12/31/2016 6/15/2017 75.56% $1,476.10 8/28/2017 CREEKSIDE HEALTH AND REHABILITATION CTR $1,007.88 1/1/2016 12/31/2016 5/31/2017 87.70% $883.91 8/28/2017 CUMBERLAND CROSSINGS RETIREMENT COMM $721.69 1/1/2016 12/31/2016 6/20/2017 42.81% $308.96 8/28/2017 DARWAY HEALTHCARE & REHABILITATION CTR $833.68 1/1/2016 12/31/2016 5/2/2017 81.48% $679.28 8/28/2017 DOYLESTOWN CARE AND REHABILITATION CTR $1,493.16 1/1/2016 12/31/2016 6/6/2017 89.74% $1,339.96 8/28/2017 DUNMORE HEALTH CARE CENTER $1,144.76 1/1/2016 12/31/2016 4/13/2017 77.94% $892.23 8/28/2017 EDINBORO MANOR $1,505.60 1/1/2016 12/31/2016 5/22/2017 72.26% $1,087.95 8/28/2017 EDISON MANOR NURSING AND REHAB CENTER $1,468.27 1/1/2016 12/31/2016 4/13/2017 85.72% $1,258.60 8/28/2017 ELMWOOD GARDENS OF PRESBY SENIOR CARE $634.59 1/1/2016 12/31/2016 7/14/2017 60.01% $380.82 8/28/2017 EMMANUEL CENTER FOR NURSING AND REHAB $1,119.87 1/1/2016 12/31/2016 7/6/2017 53.94% $604.06 8/28/2017 EPHRATA MANOR $1,493.16 1/1/2016 12/31/2016 7/6/2017 57.00% $851.10 8/28/2017 EPWORTH HEALTHCARE AND REHAB CENTER $1,269.19 1/1/2016 12/31/2016 5/2/2017 71.98% $913.56 8/28/2017 EXETER GREENS CARE & REHABILITATION CTR $1,542.93 1/1/2016 12/31/2016 6/6/2017 82.65% $1,275.23 8/28/2017 FAIR ACRES GERIATRIC CENTER $11,298.24 1/1/2016 12/31/2016 7/14/2017 94.02% $10,622.61 8/28/2017 FAIRVIEW MANOR $1,505.60 1/1/2016 12/31/2016 5/22/2017 68.98% $1,038.56 8/28/2017 FORBES CENTER FOR REHAB & HEALTHCARE LLC $2,326.84 1/1/2016 12/31/2016 7/6/2017 82.37% $1,916.62 8/28/2017 FOREST CITY NURSING AND REHAB CENTER $1,642.48 1/1/2016 12/31/2016 3/27/2017 72.93% $1,197.86 8/28/2017 FOREST PARK HEALTH CENTER $1,418.50 1/1/2016 12/31/2016 5/2/2017 72.08% $1,022.45 8/28/2017

  • Cost

    Current Name HAI

    Surcharge

    Report Begin Date

    Cost Report

    End Date Acceptance Letter Date

    MA Occupancy

    HAI Payment RA Date

    FORESTVIEW $995.44 1/1/2016 12/31/2016 5/31/2017 36.31% $361.44 8/28/2017 FOX SUBACUTE AT CLARA BURKE $746.58 1/1/2016 12/31/2

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