Medicaid Nursing Home Rates by State

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Arkansas

Medicaid nursing facility payment · Cost-based · researched October 2026

Arkansas’s Medicaid agency and its state plan are the official source for these rules. This page summarizes them as researched in October 2026; check the state’s own documents, listed under Sources, before relying on them.

At a glance

Rate method

Cost-based

Case-mix level

None

Classification

None

Rate updates

Once a year

Managed care (LTC)

No

Quality program

None

Paid outside the rate

None

Bed hold

Hospital and leave

Published rates

Not published

Assisted living

Covered

Personal needs allowance

$40 / month

Overview

• Arkansas pays each home its own prospective per diem, built from its desk-reviewed state cost report (DOM-400, fiscal year ending June 30).
• The per diem has five parts.
• (1) Direct care at the home's actual allowable Medicaid cost, capped at 105% of the 90th-percentile home.
• (2) Indirect, administrative and operating costs as one flat 'class rate' for every home: 110% of the statewide median.
• (3) A fair rental value (FRV) capital payment, with a minimum-occupancy floor.
• (4) A Quality Assurance Fee pass-through.
• (5) A small emergency-generator add-on for some homes.
• There is no case-mix (acuity) adjustment.
• Each July 1 a home is paid an interim rate (its prior rate x inflation).
• Once the new cost reports are reviewed, a weighted rate for the rest of the year trues the year up to the newly calculated actual rate.
• The current method is Attachment 4.19-D, which is the 'Manual of Cost Reimbursement Rules for Long Term Care Facilities' (last NF revision SPA 22-0013, effective 8/1/2022).
• No facility-level rate file is posted.

What matters in Arkansas

• No acuity adjustment: each home gets one cost-based per diem, with direct care repaid at actual cost up to a high ceiling.
• Overhead is one flat class rate for every home: 110% of the statewide median, rebased every year since August 2022.
• Capital minimum occupancy rises to 75% for SFY2027 rates; about 120 of 221 homes average below 75% occupancy.
• Medicaid pays the full Medicare Part A coinsurance for dual eligibles, not the lesser-of amount most states use.
• Hospital bed holds are paid only at 85%+ occupancy; only about 46 of 221 homes average that level.
• No managed care, quality program, or supplemental payments: the per diem is nearly all the Medicaid money.

Frequently asked

Does Arkansas Medicaid adjust nursing home rates for resident acuity?

No. Each home gets one facility-specific cost-based per diem. Direct care is paid at actual cost up to 105% of the 90th-percentile home, and no RUG or PDPM case-mix index is used.

How does Arkansas Medicaid pay Medicare Part A coinsurance for dual-eligible nursing home residents?

In full. The state plan pays Part A coinsurance at the Medicare rate for all services except inpatient hospital. DHS's 2024 Sustainability Review confirmed full payment for nursing facility services.

When does Arkansas Medicaid pay a nursing home to hold a bed during hospitalization?

Only for up to 5 consecutive days, and only if the home was at least 85% occupied on the last day of the billing month. About 46 of 221 homes average 85% or more.

How much is paid outside the posted rate in Arkansas?

None found; no UPL, IGT, directed or quality payments since the public-home UPL ended in 2004.

Does Arkansas require a minimum share of spending on care?

No; the direct care floor and repayment rule expired in July 2004.

How is the Arkansas nursing home provider tax charged?

Quality Assurance Fee per patient day on all payers, sized to 6% of gross receipts; no exemptions; repaid on Medicaid days.

How the rate is set

How the method got here

Verified October 11, 2026

Cost basis

Uses cost reports

Yes

Cost report

Arkansas state cost report (Financial and Statistical Report, DOM-400 forms; 'Medicare (Title XVIII) cost reporting forms are not acceptable in lieu of these forms'). Filed for a fiscal year ending June 30, due 90 days later through the LTC cost report web application (since 8/1/2022; was 75 days). The facility's latest Medicare cost report must also be submitted. Desk reviewed by DHS.

Base year and rebasing

Rebased every year from the prior state fiscal year's desk-reviewed cost reports. Since 8/1/2022 both direct care and the indirect/administrative/operating class rate are rebased annually; the IAO class rate was rebased 'at least once every three years' before then. Only full-year cost reports set the direct care ceiling and the class-rate median; change-of-ownership reports set only that home's own components. On July 1 each home gets an interim rate (prior actual per diem x inflation). After the new reports are reviewed, the rest of the year is paid at a weighted rate: [(Actual x 12) - (Interim x months used)] / months remaining. The rate table pairs SFY2022 cost reports with SFY2023 rates, and so on.

Components

Component	Method	Notes
Direct care	Facility-specific actual allowable Medicaid direct care cost per day, inflated to the rate period. Ceiling = 105% of the per diem at the 90th percentile of arrayed facility direct care costs. Rebased annually.	Includes salaries and contract costs for aides, medication assistants (added 2022), LPNs, RNs, DON/ADON, PT/OT/speech and other therapists, rehab aides, and direct care benefits and training. Also OTC drugs, oxygen, direct care medical supplies, therapy supplies, nursing consultants, raw food, food supplements and incontinence supplies. The 90%-of-median floor (with repayment if a home underspent) expired 7/1/2004; its language was deleted 8/1/2022.
Indirect, administrative and operating (IAO)	Class rate: one per diem paid to every home = 110% of the median IAO per diem cost, inflated. Rebased annually since 8/1/2022.	Homes below the median keep the difference; homes above it absorb the excess. Covers administrator, dietary, housekeeping, laundry, maintenance, activities, social services, medical records, management fees/home office, utilities, and similar costs. Owner/administrator pay is limited to 150% of the median wage for comparable positions in homes without owner-operators, in three bed-size peer groups (<75, 75-149, 150+ licensed beds).
Fair market rental (capital)	Fair rental value in place of actual property costs. (Return on equity + 2.5% rental factor + cost of ownership) / greater of actual days or minimum-occupancy days. See capital and occupancy_rules.	Room-class per bed values from the CY2023 rate year: Class A private room with private or shared-adjoining bath $196,977; Class B semi-private with attached bath $140,594; Class C (any other room) frozen at the 6/30/2022 value with no further index.
Quality Assurance Fee component	Pass-through: 'reimbursed at the amount established as the multiplier as defined in Act 635 for the date of service billed'.	The current per-day multiplier was not found in a primary source.
Emergency generator add-on	Only for first-time generators installed to meet Act 1602 of 2001. (Projected yearly depreciation over 10 years + up to 5 years of interest, or lease expense up to 10 years) / greater of actual days or minimum-occupancy days. Reset each January 1.	Legacy add-on that runs out as generators are fully depreciated.

Inflation

CMS Skilled Nursing Facility Market Basket Index, using the Four Quarter Moving Average Percent Change for the final quarter of the rate period (since 8/1/2022). Before that it was the S&P/DRI SNF Market Basket without capital, %MOVAVG for the quarter ending June 30. Used to inflate cost-report costs to the rate period and to set the July 1 interim rates.

Verified October 11, 2026

Case mix

System

None

Applied at

None

How it works

Acuity does not reach payment. Every Medicaid resident in a home is paid the same facility per diem, built from that home's cost report (4.19-D section 2-4 A).

Classification

none

Applies to

none

Acuity measured from

Not applicable. The only MDS use in the plan was the 2002-2003 non-state public nursing facility UPL adjustment. It ran residents' MDS through the Medicare 44-group RUG system to estimate a Medicare-equivalent rate, and was eliminated 1/1/2004.

Updated

Not applicable

Move to PDPM

None. Arkansas never used RUG-based Medicaid NF rates (MACPAC 2019 also reported no acuity system), so CMS ending OBRA RUG support in Oct 2023 forced no change. No PDPM proposal was found in the 2022 rule, SPAs 2020-2026, or the 2024 Medicaid Sustainability Review.

Verified October 11, 2026

Low-acuity residents

None. The 4.19-D method produces one per diem per home, paid for every Medicaid resident whatever their acuity. MMIS revenue codes still separate levels of care (190 Skilled, 191 Intermediate I, 192 Intermediate II, 193 Intermediate III), but the plan sets no level-specific or reduced rate. People who do not meet nursing home medical need criteria (Office of Long Term Care medical need determination, 20 CAR pt. 405) are not covered; they are not paid at a lower rate. Checked: 4.19-D (CAR pt. 570/579, SPA 22-0013), the DHS Long Term Care codes page, and the 2022 rule packet.

Verified October 11, 2026

Capital

Fair rental value (4.19-D section 2-4 A.1.C, revised 8/1/2022). Current Asset Value (CAV) = beds x per bed value (PBV) less an aging index of 1% per year of age, capped at a 50% reduction. Renovations of at least 10% of per bed value (5% for common areas) reduce the aging index, with plans pre-approved by DHS. PBV is set by room class from the CY2023 rate year: Class A private $196,977, Class B semi-private with attached bath $140,594, both indexed yearly. Class C is frozen at the 6/30/2022 PBV. The index is the lesser of the Marshall & Swift Little Rock masonry or wood-frame change, or 5%. DHS must compare the index to actual Arkansas SNF construction costs every 5 years and rebase if costs ran higher. Payment = (return on equity + facility rental factor + cost of ownership) / greater of actual days or minimum-occupancy days. Return on equity = (CAV minus fixed-asset debt) x (June Moody's Seasoned Baa yield + 1.5%), max 10%. Rental factor = 2.5% of CAV. Cost of ownership = actual interest, property taxes, and property and professional liability insurance (liability capped at $2,500 per licensed bed). Minimum occupancy: 60% (SFY2023 rates), 65% (SFY2024), 70% (SFY2025-2026), 75% (SFY2027 on); it was 80% before 8/1/2022. New homes use 50% occupancy for their provisional rate. Minor equipment under $2,500 is expensed (was $300). Home Style (small-house) beds apply occupancy separately.

Verified October 11, 2026

Budget adjustment factor

None found. No across-the-board cut, budget-neutrality factor or rate freeze appears in 4.19-D. The only limit beyond the ceilings is the charges test in section 2-3: if a home charges other long-term care payers less than 80% of its Medicaid rate (public homes giving free or nominal-charge care excepted), its weighted average Medicaid payment is reduced to no more than 125% of its weighted average reimbursement from those payers. The 2022 rewrite was not budget neutral: DHS estimated +$55M (SFY2023) and +$60M/yr total spending.

Verified October 11, 2026

Add-ons and money outside the rate

Paid outside the posted rate

Level

none

Estimate

About 0% of base. No UPL, IGT, directed payment, quality pool or lump-sum program for nursing homes exists in the current state plan or SPAs 2020-2026. The public-home UPL payment ended 1/1/2004. Arkansas Health Center's retrospective cost settlement is its rate method, not an add-on.

Components

None.

Source

https://codeofarrules.arkansas.gov/Rules/PartDocument?partID=…

Verified October 11, 2026

Payments by owner type

Applies

yes

Detail

Narrow. The state-operated Arkansas Health Center Nursing Facility is paid actual allowable cost with semi-annual retrospective settlement, outside the direct care ceiling and IAO class rate that bind every other home. It may also include prescription drug costs. Other government homes get the standard method: CMS lists 5 county, 1 city, 1 city/county and 3 state-owned homes among 221 AR SNFs, and the method treats them the same. The IGT-funded public-home UPL payment existed 2002-2003 only.

Funding

State general revenue with federal match; no IGT.

Source

https://humanservices.arkansas.gov/wp-content/uploads/LTCReim…

Verified October 11, 2026

Quality program

Active

No

Notes

None found. Attachment 4.19-D (full NF section in the Code of Arkansas Rules pt. 570, current through Sept 2026) has no quality, value-based or performance payment. No Arkansas SPA from 2020-2026 on medicaid.gov adds one: the only 4.19-D SPAs are 22-0013 (methodology) and 26-0005 (appeal time limits). MACPAC 2019 also reported none. PASSE and PCMH have incentive programs, but they do not cover nursing homes.

Verified October 11, 2026

Provider tax

Charged

per patient day (all payers, including Medicare and private pay; multiplier set to raise 6% of aggregate gross receipts)

Standard amount

Fixed multiplier per patient day, recalculated annually by DMS to equal 6% of aggregate annual gross receipts (Act 635 of 2001, sec. 2). $5.25/day initially (3/9/2001-6/30/2001); the current amount was not found.

Lower for high-Medicaid homes

no

Returned in the rate

Yes, per day. The per diem includes a Quality Assurance Fee component equal to the multiplier for the date of service, so the fee on Medicaid days is repaid. The fee is also an allowable cost, and its funds may only pay NF reimbursement. The statute says no home is guaranteed to get back as much as it pays.

Source

https://codeofarrules.arkansas.gov/Rules/Rule?levelType=secti…

Verified October 11, 2026

Provider tax notes

Nursing Home Quality Assurance Fee (Act 635 of 2001; Ark. Code 20-10-1601 et seq.; 20 CAR pt. 577). The fee is a fixed dollar 'multiplier' x patient days from the midnight census of all residents, plus hospital holds of up to 5 days and home-leave holds of up to 14 days. It is reported monthly, billed by the 15th and due by the 30th. The multiplier was $5.25 at the start (3/9/2001-6/30/2001). By statute it is recalculated yearly to raise 6% of aggregate annual gross receipts, and 'the rules ... shall not grant any exceptions'. The fee is an allowable cost, and the per diem includes a QAF component equal to the multiplier for each Medicaid day. Fee revenue sits in a designated account of the Arkansas Medicaid Program Trust Fund and, with federal match, may be used only for NF reimbursement. The current multiplier was not found in a primary source.

Verified October 11, 2026

Supplemental payments

None current. The Non-State Public Nursing Facility Adjustment ran 2/21/2002 to 1/1/2004. It was a monthly UPL payment bringing public NF payments up to a Medicare-related upper payment limit, built from Medicare RUG rates, and was eliminated effective 1/1/2004 (4.19-D section 2-4 A.8). No IGT, UPL, directed payment or provider-tax-funded supplemental pool for nursing homes was found in the state plan or SPAs 2020-2026.

Verified October 11, 2026

Other add-ons

(1) Emergency generator add-on (Act 1602 of 2001), only for first-time generators, reset each January 1 until the depreciation, interest or lease period runs out. (2) Home Style beds (small-house model certified by the Office of Long Term Care) get capital calculated separately, with their own occupancy test, a separate cost report and universal-worker CNA cost treated as direct care. The $65,000 Home Style PBV language was deleted 8/1/2022 and now follows the general PBV rules. (3) Hospice room and board is billed under revenue codes 658/659. No COVID-era, ventilator, behavioral or bariatric per diem add-on was found.

Verified October 11, 2026

Units paid separately

(1) Arkansas Health Center Nursing Facility (state-operated, Benton) is a 'Special Class'. It gets actual-cost reimbursement with an interim per diem from its latest semi-annual cost report and retrospective settlement, outside the ceilings and class rate (4.19-D section 2-4 C). It may also report prescription drug costs. (2) Ventilator equipment for NF residents is paid separately to DME vendors under the Ventilator Equipment program with prior approval; a nursing facility counts as a 'place of residence'. There is no separate NF ventilator per diem. (3) ICF/IID (16+ bed private, state-operated, and under-16 bed) has its own methods, including enhanced care add-ons of $10.54 and $7.02 per day. (4) New homes and first-time Medicaid enrollees get a provisional rate: direct care at the inflated ceiling, the IAO class rate, and FRV with no debt at industry-average taxes and insurance and 50% occupancy for new construction. A six-month cost report then sets a retroactive adjustment.

Verified October 11, 2026

Payment rules

Managed care for long-term care

Status

no

Detail

Fee-for-service. PASSE excludes nursing facility residents and NF services (1915(b) renewal, public hearing 10/15/2026). DHS's 2024 Medicaid Sustainability Review listed moving NF services into PASSE as an option (Option 4.1) and said it was not a recommendation; no move has been enacted.

Verified October 11, 2026

Who pays

fee_for_service. Nursing facility care is paid fee-for-service by DHS Division of Medical Services. The PASSE managed care program (Provider-Led Arkansas Shared Savings Entities, 1915(b)/(i), March 2019) serves people with serious behavioral health needs or developmental disabilities. It excludes people who live in a nursing facility and lists 'skilled nursing facility services' as an excluded service (PASSE 1915(b) renewal draft, Oct 2026). PACE operates in a few areas.

Verified October 11, 2026

Managed care rate floor

Not applicable. No managed care plan pays for nursing facility care.

Verified October 11, 2026

Included in the daily rate

Included (allowable cost categories): nursing and therapy staff, including PT/OT/speech and contract therapists, therapy supplies, OTC drugs, oxygen, medical and incontinence supplies, raw food and supplements, dietary, housekeeping, laundry, activities, social services, medical transportation, and administration. Not included (section 3-6): prescription drugs (except at Arkansas Health Center), physician, dental, dentures, podiatry, eyeglasses, appliances, X-ray, lab, and anything else billable by a direct-provider payment plan (Medicaid, Medicare Part B, other insurers). Ventilator equipment is billed by DME vendors. Homes may not charge residents or families for any item that is an allowable cost.

Verified October 11, 2026

Bed hold

Hospital stays

Paid for up to 5 consecutive days of acute hospitalization, and only if the home was at least 85% occupied on the last day of the billing month (4.19-C). Revenue codes split hospital leave at 85%+ occupancy (185/186) from under 85% (180/187). DHS reminded homes in April 2026 to bill the LOA code for hospital days. The percentage of per diem is not stated; it is billed as a covered day at the facility rate.

Leave days

Paid with no annual limit on the number of leaves, up to 14 consecutive days per leave. The plan of care must state that the physician approved home visits (4.19-C). The percentage of per diem is not stated.

Occupancy rule

85% occupancy on the last day of the billing month, for hospital leave only. About 46 of 221 Arkansas homes averaged 85%+ occupancy (CMS Provider Information, Oct 2026, certified beds); the plan's test uses the last day of the month.

Notes

Paid hold days count in the QAF midnight census (hospital up to 5 days, home leave up to 14) and as resident days on the cost report. 4.19-C dates from 3/1/1992 and was confirmed in the current state plan (CAR pt. 570).

Source

https://codeofarrules.arkansas.gov/Rules/PartDocument?partID=…

Verified October 11, 2026

Personal needs allowance

Per month

40

Effective

unknown (current state plan Attachment 2.6-A; date of the $40 amount not shown)

Notes

$40 for an individual and $80 for a couple (aged, blind, disabled); $40 for AFDC-related children and adults. Supplement 15 to Attachment 2.6-A covers groups with greater need. Not indexed to the COLA in the plan text. VA pensions limited to $90/month (38 U.S.C. 5503) are disregarded under federal rules.

Source

https://codeofarrules.arkansas.gov/Rules/PartDocument?partID=…

Verified October 11, 2026

Medicare coinsurance days

Method

full

Rule

Supplement 1 to Attachment 4.19-B (rev. 1/1/2016) codes Part A deductibles and coinsurance 'MR' (paid up to the full Medicare rate) for QMBs, other Medicaid recipients and QMB-Plus. Only inpatient hospital Part A cost sharing is 'SP', limited to the lesser of the coinsurance or the Medicaid rate minus the Medicare payment (since 2016). The plan adds: 'The payment of all other Part A deductible and coinsurance is based on the Medicare rate.' DHS's 2024 Medicaid Sustainability Review states that 'Arkansas uses a full payment claims policy for ... nursing facility services.' Medicare Advantage: the plan pays only listed copayments for duals in Medicare HMOs (ER $25, physician/chiropractor/podiatrist $5, therapy $5, psychiatry 50% or $20), and SNF cost sharing is not on that list (see open_questions).

Effect

For an Original Medicare dual eligible on SNF days 21-100, the home receives the full Part A daily coinsurance from Medicaid (less any patient liability), not the usual $0 under lesser-of.

Confidence

confirmed

Source

https://codeofarrules.arkansas.gov/Rules/PartDocument?partID=…

Verified October 11, 2026

Required care spending

Applies

no

Rule

No current rule. From 2001 to 7/1/2004, homes paid the direct care floor had to repay the gap if their actual direct care spending fell short; the provision expired 7/1/2004 and was deleted in 2022. Related, but not a spending rule: direct care is repaid at actual cost up to the ceiling, so money a home does not spend on direct care lowers its next rate rather than being kept.

Source

https://www.medicaid.gov/medicaid/spa/downloads/AR-22-0013.pdf

Verified October 11, 2026

Occupancy rules

Applies

yes

Rule

(1) Capital (FRV) and the generator add-on are divided by the greater of actual days or licensed beds x days x minimum occupancy: 60% for SFY2023 rates, 65% SFY2024, 70% SFY2025-2026, and 75% from SFY2027 (it was 80% from SFY2008 to 2022). (2) Hospital bed hold is paid only if the home was at least 85% occupied on the last day of the billing month. (3) Provisional rates for new construction assume 50% occupancy until a six-month cost report. Home Style beds apply the capital occupancy test separately. Direct care and IAO have no occupancy floor. About 120 of 221 AR homes averaged under 75% occupancy (CMS Oct 2026 file, certified beds; the median is 72%).

Source

https://www.medicaid.gov/medicaid/spa/downloads/AR-22-0013.pdf

Verified October 11, 2026

MDS accuracy penalties

None. There is no case-mix payment, so there are no MDS accuracy rate cuts or recoupments. Rates are adjusted retroactively to the start of the rate period after amended cost reports, desk reviews or audits (4.19-D section 2-4 A.7). Homes that cannot be audited (disclaimer) after a second attempt are terminated from Medicaid.

Verified October 11, 2026

Published rates and changes

How often rates change

A home's rate changes

annual

When

July 1 (state fiscal year): an interim rate = the prior actual per diem x CMS SNF market basket. Once the new desk-reviewed cost reports produce the actual rate (no published date), a weighted per diem applies for the rest of the year so the year averages to the actual rate. Capital is recalculated when beds are added or major renovations are approved, and the generator add-on resets each January 1. There is no per-resident or quarterly acuity change.

Verified October 11, 2026

When rates change

State fiscal year (July 1-June 30). The interim rate starts July 1 and the weighted actual rate starts mid-year after desk review. The 2022 plan text also refers to a 'CY 2023 rate year' for the room-class PBV and the 60% occupancy step, while its table pairs SFY2022 cost reports with SFY2023 rates (see open_questions). The QAF component follows the multiplier for each date of service. Rate appeals are due within 65 calendar days of the DHS notice of the final rate (SPA 26-0005, effective 6/1/2026).

Verified October 11, 2026

Posted rates

Home-level rates published

No

Where

None found. DHS's Fee Schedules page lists no nursing facility rates, and the Office of Long Term Care Cost Reimbursement Rules page posts only the manual. Rates are sent to each facility, and appeal rights run from the DHS rate notice.

Format

none

Cadence

n/a

History

n/a

Home identifier

n/a

Verified October 11, 2026

Rate build-ups

Published

No

Where

Not posted. Each home receives a DHS rate notice for its final rate; the 65-day appeal clock runs from that notice. The direct care ceiling, IAO class rate, median, and PBV/inflation values for each year are not posted on the DHS site.

What they show

Not available publicly.

Format

none

Verified October 11, 2026

Recent changes

Verified October 11, 2026

Assisted living

Medicaid assisted living

Covered

yes

Program

Living Choices Assisted Living waiver, a 1915(c) HCBS waiver run jointly by the Division of Aging, Adult, and Behavioral Health Services and DMS (20 CAR pt. 574 and pt. 629). It serves people 21+ who meet intermediate nursing facility level of care, in licensed Level II assisted living facilities, or through Class A home health agencies under contract with one.

What is paid

Services only: a statewide daily rate for the bundled direct care services in the person-centered service plan. 'Room and board are to be paid by the client or his or her legal representative.'

Rate

$86.73/day (procedure T2031), urban and rural, set from the 2023 Myers and Stauffer rate study for SFY2025 and kept for SFY2026. The fee schedule still showed $86.73 as of 9/3/2026. Before that it was $81.59 urban and $85.67 rural. The draft 2025 rate study (7/31/2026) offers four options: keep $86.73, or move to $89.40, $91.41 or $93.44.

Limits

Only Level II ALFs can enroll (53 providers filed 2025 cost surveys). DPSQA may impose temporary caps or moratoria on new ALF providers. Waiver slot caps and waitlists were not confirmed.

Source

https://humanservices.arkansas.gov/wp-content/uploads/2025-Ar…

Verified October 11, 2026

Sources

1. Manual of Cost Reimbursement Rules for Long Term Care Facilities (= Attachment 4.19-D), last revised 08/01/2022 · state plan
2. DHS Office of Long Term Care Cost Reimbursement Rules provider page · agency page
3. Code of Arkansas Rules, 20 CAR pt. 570 Arkansas Medicaid State Plan (full PDF, history through Ark. R. 2026-117, eff. 9/1/2026): Att. 4.19-B Supp. 1, 4.19-C, 4.19-D, 2.6-A · state plan
4. Code of Arkansas Rules, 20 CAR pt. 579 Manual of Cost Reimbursement Rules for Long-Term Care Facilities · regulation
5. 20 CAR pt. 577 Administrative Procedures of Nursing Home Quality Assurance Fee (secs. 577-101, -103) · regulation
6. Act 635 of 2001 (HB1274), An Act to Levy a Quality Assurance Fee upon Nursing Facilities · statute
7. CMS approval, SPA AR-22-0013 (LTC cost reimbursement manual; eff. 8/1/2022; federal impact $7.16M FFY2022, $42.97M FFY2023) · state plan
8. CMS approval, SPA AR-26-0005 (4.19-D provider reconsideration and appeal time limits; eff. 6/1/2026) · state plan
9. Rule 016.29.22-001 Skilled Nursing Facility Payment Methodology: proposed rule packet with financial impact statement and rule summary · regulation
10. Rule 016.29.22-001 final filing (8/3/2022) · regulation
11. Arkansas Medicaid Sustainability Review (DHS, draft final 3/26/2024) · agency page
12. PASSE 1915(b) Waiver Renewal (public notice; hearing 10/15/2026) · agency page
13. DHS Codes page: Long Term Care Codes (revenue codes incl. LOA by occupancy; updated 1/28/19) · agency page
14. Remittance Advice messages 4/23/26-4/30/26: Guidance for Nursing Home Leave of Absence · agency page
15. Arkansas Medicaid Provider Manual Section I (QMB / crossover policy) · agency page
16. Ventilator Equipment Provider Manual Section II · agency page
17. 2025 Arkansas Living Choices Assisted Living Waiver Rate Study Report (Myers and Stauffer, draft 7/31/2026) · agency page
18. Living Choices Assisted Living fee schedule (T2031 $86.73) · rate file
19. Living Choices Assisted Living Provider Manual Section II · agency page
20. DHS Fee Schedules page (no nursing facility rates listed) · agency page
21. CMS Nursing Home Provider Information (snapshot 10/8/2026; AR facility count, ownership, beds, average residents) via local cms_providers table · secondary
22. MACPAC Nursing Facility Payment Policies compendium (2019 baseline, out of date) · secondary

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