Page 2946

year’s facility-specific Medicaid routine average capital cost;

(3) the ancillary capital portion of the prospective per-day payment rate is determined by calculating the percentage of capital cost for each ancillary cost center, multiplying the percentage by the related Medicaid patient ancillary costs from the base year adjusted Medicare cost report, by cost center, and totaling the calculated capital costs from all cost centers; the resulting total is divided by the sum of the Medicaid patient days from the base year and updated to the prospective year based on adjustment factors identified in 7 AAC 150.150;

(4) the noncapital ancillary portion of the prospective per-day rate is the sum of Medicaid inpatient noncapital ancillary costs from the base year divided by the facility’s Medicaid patient days from the base year; the resulting per-day inpatient noncapital ancillary cost is updated to the prospective year based on adjustment factors identified in 7 AAC 150.150; total Medicaid inpatient ancillary costs less the capital portion of the Medicaid inpatient ancillary costs as determined in (3) of this subsection equals the total noncapital Medicaid inpatient ancillary costs to be used for this portion of the rate;

(5) for purposes of this subsection, nursery days constitute patient days and swing-bed days do not constitute patient days;

(6) for purposes of this subsection, the costs associated with swing-bed services, determined by multiplying the number of swing-bed days by the swing-bed rate in effect in the base year, are removed before calculating the acute care per-day rate;

(7) for purposes of this subsection, Medicaid patient days are

(A) the covered days from the MR-0-14 report for routine noncapital and routine capital costs; and

(B) facility-reported Medicaid patient days for ancillary noncapital and ancillary capital costs; after re-basing, the department may use either facility-reported Medicaid patient days or covered days from the MR-0-14 report for ancillary noncapital and capital costs;

(8) for purposes of this subsection, and except for critical access hospitals designated under 7 AAC 12.190, costs are the lower of

(A) Medicaid inpatient costs; the department will calculate those costs as the sum of