Skilled Nursing Facilities

Creating Rates

Resident Rates are used in census and rates of the Resident record. 

Rates must be configured for each Payer for each applicable schedule and room rate for each facility.

  1. Admin > Setup > Payer Rules & Rates.

  2. Locate the Payer and the applicable rate line.

  3. Click edit rates.

Configuration Options

  • Effective Date Range:  - Verify the Effective Date Range.

  • Schedule: - Select the applicable schedule from the list. Schedules that appear are schedules that are created for the payer.

  • Room Rate: - Select the room rate from the list.

  • R & B Revenue Account: - Select from the list.

  • R & B Coverage Revenue Account:  - Normally this is set to As Above unless Payer Rules are configured to pass to next payer to split billing between payers. 

  • R & B Days Account: - Select from the list.

  • Allow R & B Contractual Adj: - If your reimbursement from the payer is different from your standard rate, select this option. If selected you must complete Reimbursement Rates. 

  • Account: - If you select Allow R & B Contractual Adj then you must select an account from the list to book the adjusted amount.

  • Standard Rates: - Select an option for standard rates.

    • Use Rate Templates - Select if a rate template is created. Type a percentage amount and select the template.

    • Use Market Rates - Select if using a Market Rate Template.

    • Enter Manually - Select if a rate template is not created. Type the standard rate amount in the monthly and/or daily fields.

  • Reimbursement Rates: - Select an option for reimbursement rates.

    • Use Same Rates as Standard Rates - Select to automatically setup reimbursement rates the same as standard rates.

    • Use Rate Templates - select to setup reimbursement rates if a template is created. Type a percentage and select the template.

    • Enter Manually - select if a reimbursement template is not created. Type the reimbursement amount in the monthly and/or daily fields.

  • Click Save.

  • Repeat the steps until all schedules and room rates are complete for the payer.

  • Creating Rate Templates can save considerable time as they can be selected when creating rates and used in all facilities if applicable. 

  • If the standard rate schedule is set to market rates, when new market rates are created, residents with custom reimbursement rates are updated with the new market rate.