441—36.6(249L) Assessment.
	36.6(1) Applicability. All nursing facilities as defined in Iowa Code section 135C.1 that are free-standing facilities or are operated by a hospital licensed pursuant to Iowa Code chapter 135B shall pay a quarterly assessment to the department, as determined under this division, with the exception of:
	a. 	Nursing facilities operated by the state.
	b. 	Non-state government-owned or government-operated nursing facilities.
	c. 	Distinct-part skilled nursing units and swing-bed units operated by a hospital.
	36.6(2) Assessment level. Effective July 1, 2012, the assessment level for each nursing facility shall be determined on an annual basis and shall be effective for the state fiscal year.
	a. 	Effective July 1, 2019, nursing facilities with 46 or fewer licensed beds are required to pay a quality assurance assessment of $2.45 per non-Medicare patient day. Effective with assessment for the state fiscal year beginning July 1, 2021, the number of licensed beds on file with the department of inspections and appeals as of June 1 of each year shall be used to determine the assessment level for the following state fiscal year.
	b. 	Effective July 1, 2019, nursing facilities designated as continuing care retirement centers (CCRCs) by the insurance division of the Iowa department of commerce are required to pay a quality assurance assessment of $2.45 per non-Medicare patient day. Effective with assessment for the state fiscal year beginning July 1, 2021, continuing care retirement center designations as of June 1 of each year shall be used to determine the assessment level for the following state fiscal year.
	c. 	Effective July 1, 2019, nursing facilities with annual Iowa Medicaid patient days of 21,000 or more are required to pay a quality assurance assessment of $2.45 per non-Medicare patient day. Effective with assessment for the state fiscal year beginning July 1, 2021, the annual number of Iowa Medicaid patient days reported in the most current cost report submitted to the Iowa Medicaid enterprise as of June 1 of each year shall be used to determine the assessment level for the following state fiscal year.
	d. 	Effective July 1, 2019, all other nursing facilities are required to pay a quality assurance assessment of $12.75 per non-Medicare patient day.
[ARC 8258B, IAB 11/4/09, effective 1/1/10; ARC 8894B, IAB 6/30/10, effective 7/1/10; ARC 9127B, IAB 10/6/10, effective 11/10/10; ARC 9892B, IAB 11/30/11, effective 2/1/12; ARC 3872C, IAB 7/4/18, effective 9/1/18; ARC 4428C, IAB 5/8/19, effective 7/1/19; ARC 5306C, IAB 12/2/20, effective 7/1/21]