Medicaid Nursing Home Rates by State

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Connecticut

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

Connecticut’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

Facility average

Classification

PDPM

Rate updates

Quarterly

Managed care (LTC)

No

Quality program

None

Paid outside the rate

Small

Bed hold

Hospital and leave

Published rates

Rates and build‑ups

Assisted living

Limited

Personal needs allowance

$75 / month

Overview

• Each home is paid its own audited cost per day, split into five parts and capped against medians: direct care (nursing) up to 135% of its peer-group median (Fairfield County vs all other counties), indirect care up to 115% and admin/general up to 100% of the statewide median, plus uncapped capital-related costs and a fair rent (property) allowance.
• Only direct care is adjusted for acuity: the home's case-mix-neutral nursing cost is multiplied by its Medicaid case-mix index (CMI) every quarter.
• Homes below the median on indirect and admin costs keep 25% of the gap.
• On top sit a stack of legislated per-day add-ons (wage add-ons, the 7/1/2022 4.5% increase, benefit enhancement, staffing add-ons, the 7/1/2025 3% wage add-on).
• SFY2026 rate letters (7/1/2025) for 183 nursing homes: median $336.21/day, range $250.07-$782.58.
• On 7/1/2026 the base moved from 2019 to 2024 cost reports and case mix from RUG-IV to the PDPM nursing component, with a stop-gain/stop-loss corridor through SFY2028.

What matters in Connecticut

• Rates are each home's own 2019 cost (2024 cost from 7/1/2026), capped at 135%/115%/100% of medians; SFY2026 median rate $336.21/day.
• Case mix touches only direct care: one Medicaid CMI per home, quarterly; PDPM nursing replaced RUG-IV 7/1/2026 (SPA pending CMS approval).
• A statewide CMI growth cap shrinks every home's CMI: Medicaid CMI rose 12.99% from 2022 to 2025 but only 2.27% was paid.
• PDPM rebase is phased in: gains capped at $6.25/day and losses at $15.75/day in SFY2027; $10/$23 in SFY2028; none after.
• $21.02 per non-Medicare day user fee ($16.13 for municipal or 230+ bed homes); 13 of 16 CCRC homes are exempt.
• Wage add-ons must be spent on wages: 3% (7/2025), 3% (7/2026), 4% (1/2027); unspent money is recouped plus up to 50% penalty.

Frequently asked

How does Connecticut limit growth in nursing home case-mix payments?

A statewide neutrality factor scales down every home's Medicaid CMI when the statewide average grows past a cap. For SFY2026 the cap was 2.27% over early 2022, though CMI had risen 12.99%. Under PDPM the caps are 1%, 2% and 3% for SFY2027-2029.

Does Connecticut Medicaid pay nursing homes a price or each home's own cost?

Each home's own audited cost per day, capped at 135% (direct, by peer group), 115% (indirect) and 100% (admin) of medians. Rates used 2019 costs from 7/1/2022 through 6/30/2026, then 2024 costs from 7/1/2026.

When does Connecticut pay nursing homes to hold a Medicaid resident's bed?

At the full per diem for up to 15 days per hospital stay (7 days, then 8 more after a hospital check) and 21 home-leave days a year, but only if the home has at most 3 (hospital) or 4 (leave) vacant beds or percent.

How much is paid outside the posted rate in Connecticut?

Small: a $2.5-5 million Medicaid utilization pool and a $10 million benefits pool, well under 1% of base payments.

What does Connecticut Medicaid pay on Medicare coinsurance days?

Lesser-of: combined Medicare and Medicaid payment cannot exceed the Medicaid rate, so coinsurance is usually $0.

Does Connecticut require a minimum share of spending on care?

Yes; legislated wage add-ons must go to wages, verified by DSS, with recoupment and civil penalties up to 50% of unspent funds.

How is the Connecticut nursing home provider tax charged?

$21.02 per non-Medicare resident day; $16.13 for municipal or 230+ bed homes; 13 CCRC-owned homes exempt; no Medicaid-share discount.

How the rate is set

How the method got here

Verified October 11, 2026

Cost basis

Uses cost reports

Yes

Cost report

Annual Report of Long-Term Care Facility (state form), cost year ending September 30; desk reviewed by Myers and Stauffer. For-profit homes must include profit and loss statements of related parties paid $50,000+ a year.

Base year and rebasing

CGS 17b-340d(a)(9): rebase no more often than every 2 years and no less often than every 4 years; no inflation in a rebase year; no rebase for SFY2026 (P.A. 25-168 §330). Acuity rates from 7/1/2022 used cost year ending 9/30/2019, inflated to mid-SFY2022 (multiplier 1.167 in later rate sheets). SPA 26-0021 rebases to the 2024 cost year effective 7/1/2026.

Components

Component	Method	Notes
direct care	Own cost per day (nursing salaries, fringe, agency nursing) / greater of actual days or 90% occupancy, normalized by the home's all-payer cost-year CMI, capped at 135% of the peer-group median, then multiplied by the home's quarterly Medicaid CMI (after the statewide neutrality factor). No efficiency incentive.	Peer groups: Fairfield County vs non-Fairfield. 2019-base limits: $211.61 (Fairfield) and $190.78 (others). The PDPM 2024-base example shows medians of $135.17 (Fairfield) and $130.91 (others) before the 135% cap.
indirect care	Own cost per day capped at 115% of the statewide median; homes below the median get a 25% efficiency incentive (CGS 17b-340d(a)(8)). Not case-mix adjusted.	Professional fees, dietary, housekeeping, laundry, patient-care supplies. 2019-base limit $74.77.
administrative and general	Own cost per day capped at 100% of the statewide median, with the 25% efficiency incentive below the median.	Includes plant operation and maintenance. 2019-base limit $40.72. The 2024 excess-bed work group noted over half of homes are paid above their actual A&G cost.
capital-related costs	Property taxes, insurance, moveable equipment leases and depreciation: own cost per day, no maximum.	Current rate sheets show one 'Capital' line; the 2022 demonstration sheet listed 'Capital/Other' and 'Provider Tax' separately, so the user fee appears to be reimbursed as a cost here (inference; see open_questions).
fair rent (property) and return on equity	Fair rent: base value of real property amortized over its remaining useful life plus a rate of return tied to the Medicare borrowing rate (max 11%); floor at the 25th percentile of statewide fair rent. Non-profits get the lower of fair rent or actual interest plus depreciation. New fair rent additions are added each July 1 within appropriations.	7/1/2024 rate report: median fair rent $6.42/day (max $31.19); median ROE $0.16/day.
legislated add-ons	Per-day add-ons outside the cost components: wage add-on (median $19.50 on 7/1/2024; rolls in 2019-2021 wage increases), 7/1/2022 4.5% increase (median $11.91), benefits enhancement add-on (121 homes, median $3.67), social worker and direct-care minimum staffing add-ons, and from 7/1/2025 a 3% wage add-on.	The 3% add-on = 3% of the home's nursing, aide, dietary, housekeeping, laundry and maintenance salaries plus fringe, divided by resident days (example $4.82/day).

Inflation

GDP deflator (four quarters ending March 31) only when funding is appropriated (CGS 17b-340d(a)(11)). No inflation increases for SFY2022-SFY2027 beyond those built into the 2022 acuity transition (P.A. 25-168 §331). The 2022 transition revised the inflation update to run from mid-cost year to mid-rate year (11/2022 revised rates).

Verified October 11, 2026

Case mix

System

PDPM

Applied at

Facility average

How it works

The home's direct care cost is multiplied by one day-weighted Medicaid CMI for the quarter, so every Medicaid resident in a home gets the same rate (SPA 26-0021; DSS July 2025 webinar).

Classification

From 7/1/2026: PDPM nursing component only, October 2025 federal PDPM nursing weights (SPA 26-0021; DSS April 2026 webinar). 7/1/2022-6/30/2026: RUG-IV 48-group grouper, kept alive with CMS's optional state assessment (OSA) through 9/30/2025.

Applies to

Direct care component only.

Acuity measured from

Two calendar-day-weighted indices of active MDS assessments accepted by CMS: an all-payer 'normalizing' CMI for the cost-report year and a quarterly Medicaid CMI. Quarterly cycle with one-quarter lag: MDS for Jan-Mar sets the 7/1 rate, Apr-Jun sets 10/1, Jul-Sep sets 1/1, Oct-Dec sets 4/1. Every Medicaid CMI is then reduced by the statewide neutrality factor when the statewide average exceeds the growth cap.

Updated

Quarterly (1/1, 4/1, 7/1, 10/1). CMI was frozen for 4/1/2026 rates during the PDPM switch.

Move to PDPM

CMS ended RUG support; Connecticut collected OSA data through 9/30/2025 and set RUG-based rates through 1/1/2026, froze CMI for 4/1/2026, and switched to the PDPM nursing component with a rebase to cost year 2024 on 7/1/2026 (SPA 26-0021, public comment to 7/16/2026). Corridor vs each home's 6/30/2026 rate: max gain $6.25 / max loss $15.75 (SFY2027), $10.00 / $23.00 (SFY2028), none (SFY2029). Statewide CMI growth caps vs 7/1/2026 baseline: 1.00%, 2.00%, 3.00% (the SPA's draft 4.19-D page 59c(13), which supersedes the April 2026 webinar's 0.75%/1.50%/2.25%). Approval pending: as of 10/11/2026 DSS still lists SPA 26-0021 as a current (unapproved) notice, no CMS approval was found, and no SFY2027 rate letters are posted; DSS's acuity page says PDPM is used from 7/1/2026. DSS estimates the switch cuts spending by about $18.39M in SFY2027 and $22.42M in SFY2028.

Verified October 11, 2026

Low-acuity residents

None found. There is no reduced or flat rate for residents in the lowest RUG/PDPM groups; they only lower the home's average Medicaid CMI. Checked: CGS 17b-340d, SPA 26-0021, DSS acuity webinars (2021, 2025, 2026), RCSA 17b-262-701 to 711.

Verified October 11, 2026

Capital

Fair rent for real property (amortized base value plus rate of return linked to the Medicare borrowing rate, capped at 11%, floor at the 25th percentile of statewide fair rent; non-profits get the lower of fair rent or actual interest and depreciation) plus a return on equity and uncapped capital-related costs (property tax, insurance, moveable equipment). Pro rata fair rent increases for new property additions are added each July 1 within available appropriations (CGS 17b-340d(a)(6)-(7)). New beds are barred by a certificate-of-need moratorium since 1991.

Verified October 11, 2026

Budget adjustment factor

(1) Statewide case-mix neutrality factor: when the Medicaid-day-weighted statewide CMI grows past a cap over its baseline, every home's Medicaid CMI is cut by the same percentage. Caps: 0.75% (SFY2023), 1.51% (SFY2024), 2.27% (SFY2025, held for SFY2026); statewide CMI rose 12.99% from 2022 Q1 to 2025 Q1, so the factor applied (example factor 0.9163 on the SFY2026 sample sheet). Under PDPM: 1.00%/2.00%/3.00% for SFY2027-2029. (2) No inflation increases for SFY2022-SFY2027. (3) No rebase for SFY2026. (4) Stop-gain/stop-loss corridors in phase-in years.

Verified October 11, 2026

Add-ons and money outside the rate

Paid outside the posted rate

Level

small

Estimate

Under 1% of base payments. Off-rate money is about $12.5M in SFY2027 ($2.5M utilization pool + $10M benefits pool) against base Medicaid nursing home payments on the order of $1.5B a year (183 homes at a median of about $336/day; base estimate is ours, not DSS's). SFY2028's $55M supplemental (about 3-4%) may be paid as rate add-ons.

Components

Medicaid utilization pool $2.5M (SFY2027), $5M (SFY2028+); pension/health pool $10M gross (SFY2027); $55M wage supplemental (SFY2028); proposed quality pool $10M (SFY2029). No UPL/IGT/directed payments.

Source

https://portal.ct.gov/dss/-/media/departments-and-agencies/ds…

Verified October 11, 2026

Payments by owner type

Applies

no

Detail

No payments limited to public or county homes and no IGT-funded supplements. Owner type affects only the provider tax: municipally owned homes pay $16.13 instead of $21.02 per non-Medicare day, and qualifying CCRC-owned homes are exempt. Non-profits get the lower of fair rent or actual interest plus depreciation for property.

Funding

None.

Source

https://www.cga.ct.gov/current/pub/chap_211c.htm

Verified October 11, 2026

Quality program

Active

No

Program

Nursing Home Quality Performance Program under CGS 17b-340d(a)(2). Reporting-only since 7/1/2022; DSS issues individual 'what-if' reports annually from 7/1/2023. DSS's February 2023 plan to fund it with a 5% rate withhold from 7/1/2023 was not implemented (statute kept it to reports). P.A. 25-168 lets DSS pay quality incentives on or after 10/1/2026 within appropriations; the Governor's PDPM plan proposes a $10M pool starting SFY2029.

Funding

None currently. Proposed: $10M pool (state appropriation) from SFY2029 (DSS April 2026 webinar). The 2023 withhold design would have been carved from rates.

Size

$0 today; $10,000,000 proposed for SFY2029.

Paid as

Not set; the 2023 model scored homes for a share of a pool.

Measures

Measure	Source	Weight	How points are earned
CMS long-stay and short-stay quality measures (2023 model)	MDS QM		Points for achievement and improvement (2023 Myers and Stauffer model)
CoreQ resident and family satisfaction survey	State survey (UConn Center on Aging), 2024 and 2025 results posted

Eligibility

2023 design barred homes with repeated DPH deficiency citations.

Cadence

Annual reports only.

Scores published

Model scoring workbook (Jul-Sep 2023) and CoreQ results are posted on the DSS acuity page; individual facility reports are not public.

Notes

P.A. 25-168 removed the 6/30/2025 withhold-impact report and requires a 2/1/2027 report on quality program implementation.

Verified October 11, 2026

Provider tax

Charged

per non-Medicare day

Standard amount

$21.02 per non-Medicare resident day for calendar quarters from 7/1/2017 (CGS 12-263r(a)); paid quarterly. Unchanged per DSS Fees/Payment page (2026).

Tiers

Who	Test	Amount
Nursing homes owned by a municipality	public	$16.13 per non-Medicare resident day
Nursing homes licensed for more than 230 beds	size	$16.13 per non-Medicare resident day
Homes owned and operated by a registered continuing care facility (CCRC) with 75 or fewer beds, or 76-150 beds with more than 6,500 Medicare days, or exempt from CON (CMS-approved waiver)	ccrc	exempt (13 of 16 CCRC-associated homes)

Lower for high-Medicaid homes

no

Returned in the rate

As an allowable cost in the home's rate (the 2022 DSS demonstration rate sheet shows 'Provider Tax' as its own uncapped cost line, $17.42/day in the example; current sheets fold it into 'Capital'). It is therefore based on the base-year cost report (2019, then 2024), not paid as a separate pass-through. Not confirmed in the current 4.19-D text.

Source

https://www.cga.ct.gov/current/pub/chap_211c.htm

Verified October 11, 2026

Provider tax notes

Nursing home resident day user fee (CGS 12-263r, collected by the Department of Revenue Services): $21.02 per non-Medicare resident day (includes paid bed-hold days); $16.13 for municipally owned homes and homes licensed for more than 230 beds; CCRC-owned homes meeting size/Medicare tests exempt under a CMS waiver (13 of 16 CCRC homes). Reimbursed in rates as an allowable cost.

Verified October 11, 2026

Supplemental payments

(1) Medicaid Utilization Pool (SPA 26-0021, from 7/1/2026): annual payment by April 30 to homes with Medicaid payer mix above 75% on the latest cost report, shared by Medicaid days; $2.5M SFY2027, $5M from SFY2028. (2) $10M (gross) pension and health care pool for SFY2027 (P.A. 25-168 §333), for homes offering pensions with at least 2.5% employer contribution or no-premium health coverage to more than half of non-management staff; final distribution file posted 7/24/2026. (3) $55M supplemental funding for SFY2028 (P.A. 25-168 §334) for a 2.5% wage increase on 7/1/2027 and a $26/hour aide minimum by 1/1/2028 (form of payment not yet published). No UPL, IGT or county-home supplemental payments found.

Verified October 11, 2026

Other add-ons

Per-day add-ons on the rate sheet: wage add-on (legislated wage increases of 7/1/2019, 10/1/2020, 1/1/2021, 7/1/2021; median $19.50 on 7/1/2024), 7/1/2022 4.5% rate increase for wages (median $11.91), benefits enhancement add-on (Special Act 21-15, $30M gross; 121 homes, median $3.67), social worker minimum staffing add-on (1 FTE per 60 beds), direct care minimum staffing add-on (3.0 hours per resident day), 'catch-all' add-on, and 3% wage add-ons on 7/1/2025 and 7/1/2026 plus 4% on 1/1/2027 (P.A. 25-168 §332). Interim rates for ownership change, bed changes or financial distress (CGS 17b-340d(a)(14)). Strike-cost reimbursement guidelines exist. No COVID add-ons remain.

Verified October 11, 2026

Units paid separately

Ventilator units and AIDS units keep their own cost-based per diems outside the case-mix system (DSS FAQ 5/26/2022; SFY2024 letters show an 'AIDSNF' licensure rate). Costs above ceilings may be allowed for AIDS, traumatic brain injury or other specialized-service beds (CGS 17b-340d(a)(5)); separate traumatic brain injury rates are authorized (CGS 17b-340). Rest homes with nursing supervision (RHNS) are rated under the same system.

Verified October 11, 2026

Payment rules

Managed care for long-term care

Status

no

Detail

No Medicaid managed care plans pay for nursing home care. DSS issues each home's rate by letter and pays claims directly; administrative services organizations (CGS 17b-261m) do care coordination only and bear no risk.

Verified October 11, 2026

Who pays

fee_for_service: HUSKY Health (Connecticut Medicaid) is run without risk-bearing managed care plans. DSS contracts administrative services organizations for care coordination and utilization management (CGS 17b-261m) and sets each nursing home's per diem itself (CGS 17b-340d; annual DSS rate letters).

Verified October 11, 2026

Managed care rate floor

Not applicable: no MCOs pay nursing facility care.

Verified October 11, 2026

Included in the daily rate

All-inclusive per diem (RCSA 17b-262-705): nursing, medical direction, social services, recreation, specialized rehabilitative services, room and board, personal hygiene items, over-the-counter drugs (not insulin), most DME (except items payable separately under 17b-262-676), routine medical/surgical supplies (incontinence, wound, ostomy, respiratory, enteral/parenteral), oxygen concentrators, customized wheelchair services, and transport to included services. Prescription drugs are billed separately unless DSS has approved including them. Medicare Part B-covered supplies and ancillaries are excluded from allowable cost.

Verified October 11, 2026

Bed hold

Hospital stays

Paid at 100% of the per diem (CGS 19a-537(d)) for up to 7 days including the admission day if, that day, the home has no more than 3 vacant beds or 3% of capacity (whichever is greater) and the hospital could not confirm the resident won't return within 15 days; up to 8 more days if the same vacancy test is met on day 7 and the home rechecks with the hospital. Maximum 15 days per hospitalization.

Leave days

Up to 21 home-leave days per year at 100% of the per diem if, on the day of absence, the home has no more than 4 vacant beds or 4% of capacity. Homes may not charge the resident for authorized leave days.

Occupancy rule

Yes: 3 beds/3% vacancy maximum (hospital) and 4 beds/4% (home leave).

Notes

Homes must hold a Medicaid resident's bed at least 15 days unless the hospital confirms no return; paid hold days count as resident days for the user fee.

Source

https://www.cga.ct.gov/current/pub/chap_368v.htm

Verified October 11, 2026

Personal needs allowance

Per month

75

Effective

2021-07-01 (June Sp. Sess. P.A. 21-2 §318 raised it from $60)

Notes

CGS 17b-272 'personal fund allowance' for nursing home, chronic disease hospital and state institution residents. Not indexed (annual COLA indexing was repealed in 2011).

Source

https://www.cga.ct.gov/current/pub/chap_319v.htm

Verified October 11, 2026

Medicare coinsurance days

Method

lesser_of

Rule

CGS 17b-265: DSS 'shall limit reimbursement to medical assistance providers for coinsurance and deductible payments under Title XVIII ... to assure that the combined Medicare and Medicaid payment to the provider shall not exceed the maximum allowable under the Medicaid program fee schedules.' Treatment of Medicare Advantage SNF cost-sharing not found.

Effect

Medicare's SNF rate nearly always exceeds the Medicaid per diem (median about $336), so the home usually gets $0 of the day 21-100 coinsurance.

Source

https://www.cga.ct.gov/current/pub/chap_319v.htm

Verified October 11, 2026

Required care spending

Applies

yes

Rule

Legislated wage add-ons (2021 4.5% under P.A. 21-2 §323, and P.A. 25-168 §§332-334: 3% 7/1/2025, 3% 7/1/2026, 4% 1/1/2027, 2.5% 7/1/2027, $26/hour aide minimum by 1/1/2028) must fund wage increases for nursing, aide, dietary, housekeeping, laundry and maintenance staff. DSS verifies the Medicaid share (add-on x Medicaid days) with narratives and payroll registers (SFY2026 verification from about August 2026). Unspent amounts face a rate decrease or recoupment plus a civil penalty of up to 50% of the unspent amount (CGS 17b-340e, extended by P.A. 25-168 §335). Benefits-enhancement and pension-pool homes that don't provide the benefits face an equal rate decrease or recoupment. No general direct-care spending floor.

Source

https://www.cga.ct.gov/2025/ACT/PA/PDF/2025PA-00168-R00HB-072…

Verified October 11, 2026

Occupancy rules

Applies

yes

Rule

All cost components (direct, indirect, admin, capital) are divided by the greater of actual resident days or 90% of licensed bed days (CGS 17b-340d(a)(12)); exceptions for new homes, added beds (first 3 months) and changes of ownership. A home below 90% loses that share of its costs. The standard was 95% until FY2014. In the 2019 base year, 74 of 175 homes were below 90%; the 7/1/2026 rebase applies the rule to 2024 costs (statewide occupancy was 87.16% in March 2024). The 2024 excess-bed work group kept 90% and recommended recognizing voluntary bed cuts of 10 beds/10% at each July 1 rate. Bed-hold pay also requires near-full occupancy.

Source

https://www.cga.ct.gov/current/pub/chap_319y.htm

Verified October 11, 2026

MDS accuracy penalties

Annual MDS case-mix reviews by Myers and Stauffer under supportive documentation requirements (updated April 2023; PDPM version planned). Sample: greater of 25% of roster or 25 assessments (95% Medicaid). Unsupported assessments are reclassified to the supported group (lower CMI). If more than 10% are unsupported, the home must file a case-mix Validation Improvement Plan; follow-up reviews at the state's discretion. No separate dollar penalty found.

Verified October 11, 2026

Published rates and changes

How often rates change

A home's rate changes

quarterly

When

July 1 annual rate letter (rebase, add-ons, fair rent additions, neutrality factor); direct care re-multiplied by the new Medicaid CMI each 10/1, 1/1, 4/1 and 7/1 (one-quarter MDS lag). Rebase every 2-4 years (2019 base for 7/2022-6/2026; 2024 base from 7/1/2026). Mid-year changes for scheduled wage add-ons (e.g., 1/1/2027 4%).

Verified October 11, 2026

When rates change

July 1 state fiscal year; quarterly case-mix updates; 1/1/2027 4% wage add-on.

Verified October 11, 2026

Posted rates

Home-level rates published

Yes

Where

https://portal.ct.gov/dss/health-and-home-care/medicaid-nursi…

Format

PDF (one rate letter per home per SFY); xlsx quarterly case-mix rate reports and cost report data pulls

Cadence

Annual letters (July 1); quarterly rate reports

History

SFY2012-SFY2015 (xls), then annual files through SFY2026; quarterly case-mix files Q1 2024-Q4 2025. No SFY2027 (PDPM) rate file was posted as of 10/2026.

Home identifier

Connecticut Medicaid provider number (e.g., 000021684) plus name and address; no CCN or NPI.

Verified October 11, 2026

Rate build-ups

Published

Yes

Where

DSS rates page, 'Case Mix Quarterly Rate Calculation' files; individual rate sheets also go to each home through the Myers and Stauffer portal.

What they show

Per home: county and peer group, actual and imputed days, bed days, occupancy, normalizing and Medicaid CMI, neutrality factor, each component's cost, inflation multiplier, per diem, limit, incentive and final rate, fair rent, ROE, wage add-on, staffing add-ons, stop gain/loss, 4.5% increase, benefits add-on, final rate. Later quarterly files (2025) appear to be cost-report data pulls rather than rate build-ups.

Format

xlsx

Example file

https://portal.ct.gov/dss/-/media/departments-and-agencies/ds…

Verified October 11, 2026

Recent changes

Verified October 11, 2026

Assisted living

Medicaid assisted living

Covered

limited

Program

Assisted living services under the Connecticut Home Care Program for Elders (CHCPE; Medicaid 1915(c) waiver portion and state-funded portion, CGS 17b-342), delivered by DPH-licensed assisted living services agencies in: private managed residential communities (Medicaid waiver pilot CGS 17b-365 and state-funded pilot 17b-366, combined cap 125 people); state-funded congregate housing and HUD Assisted Living Conversion sites; and the Subsidized Assisted Living Demonstration in affordable housing (CGS 17b-347e, max 300 units; Department of Housing line $3.2M SFY2026, $3.4M SFY2027).

What is paid

Services only; residents pay room and board. The demonstration adds rental subsidies through the Department of Housing.

Limits

Private ALF pilots capped at 125 people combined; demonstration capped at 300 units in at least 3 towns; CHCPE eligibility (65+, nursing facility level of care for the waiver).

Source

https://www.cga.ct.gov/current/pub/chap_319y.htm

Verified October 11, 2026

Sources

1. CGS Chapter 319y: §17b-340 (rates), §17b-340d (acuity-based methodology), §17b-340e (wage enhancement penalties), §§17b-347e, 17b-365, 17b-366 (assisted living) · statute
2. Public Act 25-168 (FY2026-27 budget), §§167, 330-335 · statute
3. SPA 26-0021 notice and draft 4.19-D pages 59c(13)-(14): PDPM transition and Medicaid Utilization Pool · state plan
4. CGS Chapter 211c §12-263r: nursing home resident day user fee · statute
5. CGS Chapter 319x §§17b-320, 17b-321 (original 2005 user fee) · statute
6. CGS Chapter 319v: §17b-261m (ASO), §17b-265 (coinsurance limit), §17b-272 (personal fund allowance) · statute
7. CGS Chapter 368v §19a-537: bed reservation and reimbursement · statute
8. RCSA §§17b-262-701 to 711: Requirements for payment of nursing facilities (Cornell LII) · regulation
9. DSS Acuity Based Methodology page (presentations, CoreQ, quality program, MDS review) · agency page
10. DSS/Myers and Stauffer: CT Nursing Facility PDPM Transition and MDS Review Update (April 7, 2026) · agency page
11. Connecticut Nursing Home Rate Update webinar (July 2025): phase-in, neutrality factor, P.A. 25-168 add-ons, SFY2026 rate sheet · agency page
12. Case Mix Three-Year Phase-In stakeholder presentation (Sept 29, 2021) · agency page
13. Nursing Facility Payment Modernization FAQ (May 26, 2022) · agency page
14. DSS letter to industry: Nursing Home Quality Performance Program (5% withhold plan), Feb 23, 2023 · agency page
15. MDS Case Mix Review Enhanced Review Process (April 2023) · agency page
16. DSS Nursing Facility Rates & Census Information page · agency page
17. SFY2026 nursing facility rate letters (7/1/2025), 184 letters · rate file
18. SFY2025 and SFY2024 nursing facility rate letters · rate file
19. 7/1/2024 Case Mix Rate Report (per-home rate build-up) · rate file
20. DSS Fees/Payment page (cost categories, limits, minimum occupancy, user fee) · agency page
21. DSS Pension and Wage Increase page (P.A. 25-168 agreement, $10M pool, prior add-ons) · agency page
22. Wage Add-on SFY2026 Verification Procedures FAQ (April 2, 2026) · agency page
23. Excess Licensed Bed Capacity Work Group final report (June 2024, P.A. 23-204 §298) · agency page
24. MACPAC Nursing Facility Payment Policies compendium, Connecticut (2019 baseline; history only) · secondary

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