Medicaid Nursing Home Rates by State

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Louisiana

Medicaid nursing facility payment · Statewide price · researched October 2026

Louisiana’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

Statewide price

Case-mix level

Facility average

Classification

Transitioning to PDPM

Rate updates

Quarterly

Managed care (LTC)

No

Quality program

None

Paid outside the rate

Small

Bed hold

Hospital and leave

Published rates

Not published

Assisted living

Not covered

Personal needs allowance

$45 / month

Overview

• Louisiana has paid a case-mix price-based per diem built from statewide prices since 1/1/2003, with no peer groups (LAC 50:II.20005).
• Per diem = facility direct care + care-related (DCCR) price + statewide administrative and operating (A&O) price + fair rental value capital + pass-through (the home's property tax and property insurance + the $12.08 provider fee) + statewide DME price + any adjustments.
• The DCCR price is 112.4% of the statewide resident-day-weighted median cost.
• It is split between direct care and care-related using each home's own base-year cost split, and the direct care part is multiplied by the home's prior-quarter facility-wide case-mix index (CMI).
• The A&O price is 107.5% of the median and is the same for every home.
• As of 7/1/2026, the statewide DCCR price is $125.23 and the A&O price is $72.56 (2025 rebase plus 3.3623% interim inflation).
• An example 7/1/2026 total rate in the state's training is $310.18/day.

What matters in Louisiana

• Homes spending below 90% of the statewide care median refund the shortfall; the floor returns to 94% on 1/1/2027.
• $5/day cap on PDPM-driven rate changes ends 12/31/2026, so some homes' rates may jump or drop.
• Case mix is per home and counts all residents of any payer, using a five-component PDPM blend updated quarterly.
• No quality incentive payment exists, and nursing home care is paid fee-for-service outside managed care.
• Bed hold pays only 10% of the rate plus the $12.08 provider fee, up to 7 days per hospital stay.
• Facility rates are not published; each home sees its own rate only through a login portal.

Frequently asked

Does a Louisiana nursing home refund Medicaid money for spending too little on care?

Yes. Homes spending below 90% of the statewide care median refund the shortfall. The floor returns to 94% on 1/1/2027.

What changes Louisiana nursing home rates on 1/1/2027?

The $5 per day cap on PDPM-driven rate changes ends 12/31/2026, so some rates may rise or fall. The care spending floor also returns to 94%.

Does buying and closing a competing Louisiana nursing home earn Medicaid payments?

Yes. A home that buys and closes another Medicaid facility within 90 days and surrenders its beds receives 5 years of capital incentive payments, paid as a per diem.

How much is paid outside the posted rate in Louisiana?

Small, probably under 5% of base: Medicare-gap payments to 4 public homes and a possibly inactive government collaboration program.

What does Louisiana Medicaid pay on Medicare coinsurance days?

Lesser-of: Medicaid pays coinsurance only up to its own rate minus Medicare's payment, usually $0 for freestanding homes.

How is the Louisiana nursing home provider tax charged?

$12.08 per occupied bed day on all payers, returned as a flat $12.08 in every Medicaid per diem.

How the rate is set

How the method got here

Verified October 11, 2026

Cost basis

Uses cost reports

Yes

Cost report

Medicare SNF cost report (CMS-2540-24 for years ending 9/30/2025 and later; CMS-2552-10 for hospital-based homes) plus the Louisiana Medicaid Supplemental cost report (Excel template v6.19, dated 9/30/2025), filed with Myers and Stauffer. Due 5 months after year end. Late filing costs 5% of the monthly Medicaid payment for each month late, and the penalty grows 5% each month.

Base year and rebasing

LAC 50:II.20005.B.1: rebase at least every 2 years, using the latest unqualified audited or desk-reviewed cost reports (4+ months) available on April 1 before the July 1 rebase. LDH may rebase earlier. The last rebase was 7/1/2025, using cost reports ending in 2023. Between rebases, base medians and prices are inflated each July 1 (3.3623% for 7/1/2026). The next rebase is due by 7/1/2027. Inflation was frozen for FY2016 and FY2018 (LAC 50:II.20001.B-C).

Components

Component	Method	Notes
direct care + care-related (DCCR)	Statewide price = 112.40% of the resident-day-weighted median of [(direct care per diem / cost-report-period CMI) + care-related per diem]. The price is split into direct care and care-related using each home's own base-year percentages, and each quarter the direct care share is multiplied by the home's prior-quarter facility-wide CMI.	DCCR price $121.16 at 7/1/2025 and $125.23 at 7/1/2026. Direct care = RN, LPN and nurse aide wages, benefits and agency staff. Care-related = indirect clinical costs. Every home gets the price whatever its own cost, but must spend at least the floor (see spending_requirements). Floor = 90% of the median during the PDPM phase-in ($97.01 at 7/1/2025, $100.27 at 7/1/2026), returning to 94% on 1/1/2027 ($104.73).
administrative and operating (A&O)	Statewide price = 107.5% of the resident-day-weighted median inflated A&O cost per day; the same dollar amount for every home.	$70.20 at 7/1/2025 and $72.56 at 7/1/2026.
capital (FRV)	Fair rental value based on facility age and square footage; no capital costs from the cost report are used. See capital.	Training example: $50.07/day for a 160-bed, 14-year-old home (7/1/2026).
pass-through	The home's own base-year property tax + property insurance per day (actual days, inflated), plus the provider fee ($12.08/day since 9/1/2016).	The provider fee is the only provider-fee-funded add-on found. It returns the fee on Medicaid days dollar for dollar.
statewide DME price	A flat statewide fee for durable medical equipment and supplies, in the rate since 8/1/2005 (LAC 50:II.20005.C.6, D.4.b).	Current amount not found.
PDPM phase-in pass-through	7/1/2025-12/31/2026 only: if a home's PDPM-based DCCR differs from its 7/1/2025 RUG-III-based DCCR by more than +/-$5/day, a pass-through adjustment limits the change to $5 (LAC 50:II.20005.D.4.e).	It ends 12/31/2026, so posted rates may jump or drop on 1/1/2027.

Inflation

Index factor 'generated pursuant to 42 CFR 413.333': the CMS SNF market basket without capital. Base-year costs are inflated from the midpoint of the cost report to the midpoint of the rate year (e.g. 7.8725% from 6/30/2023 to 12/31/2025 for the 2025 rebase). In years between rebases, the prices themselves are inflated (3.3623% for 7/1/2026). Capital values are trended separately with RS Means (New Orleans).

Verified October 11, 2026

Case mix

System

Transitioning to PDPM

Applied at

Facility average

How it works

Each home gets one rate per quarter. The direct care part of the statewide price is multiplied by the home's prior-quarter time-weighted average CMI across all residents (any payer), so every Medicaid resident in the home is paid the same rate (LAC 50:II.20005.D.1.f, 20007.E.2).

Classification

PDPM since the 7/1/2025 rate setting, using a state blend of all five PDPM components: nursing 50%, PT 15%, OT 15%, NTA 12%, SLP 8%. Weights are from CMS-1802-F Table 5 (FY2025), frozen as of 10/1/2024. Before that, RUG-III 34-group index maximizer v5.20 was used (2003 to 6/2025), kept alive from 10/1/2023 with the Optional State Assessment. 'Transitioning' because a +/-$5 RUG-to-PDPM corridor runs through 12/31/2026.

Applies to

Direct care portion of the DCCR price and floor only. Care-related, A&O, capital, pass-through and DME are not case-mix adjusted.

Acuity measured from

All residents, regardless of payer. The CMI has been time-weighted since 1/1/2017 (point-in-time before): every MDS assessment active during the quarter counts, weighted by the days it was active. Rates use the prior quarter: assessments from Jan-Mar set the Jul 1 rate, Apr-Jun the Oct 1 rate, Jul-Sep the Jan 1 rate, and Oct-Dec the Apr 1 rate. Delinquent assessments (more than 121 days old, or missing items needed for a valid PDPM HIPPS code) get the lowest CMI (BC1) in every component. Unclassifiable assessments from 1/1/2025 on also get the lowest CMI. At rebase, the cost-report-period CMI is the simple average of the quarterly CMIs covering the cost report.

Updated

quarterly (Jan 1, Apr 1, Jul 1, Oct 1)

Move to PDPM

Effective 7/1/2025 (Emergency Rule 6/30/2025; final Rule LR 51:1610-1613, Oct 2025; LDH memo 1/13/2025), together with a rebase on 2023 cost reports. Two steps eased the switch through 12/31/2026: (a) a pass-through adjustment caps the RUG-III-to-PDPM change in DCCR at +/-$5/day; (b) the DCCR spending floor was cut from 94% to 90% of the median. Shadow PDPM rates were sent for Jan and Apr 2025. The OSA (needed for RUG-III since 10/1/2023) stopped for target dates on or after 4/1/2025. Fiscal note: +$4.34M/yr total.

Verified October 11, 2026

Low-acuity residents

None found. Louisiana pays one facility-average rate per home, with no reduced or flat rate for low-acuity residents. Related rules, not carve-outs: (1) Delinquent MDS assessments (over 121 days old or without a valid PDPM HIPPS code) and unclassifiable assessments get the lowest CMI in every PDPM component. This lowers the home's average CMI, and so every Medicaid resident's rate. (2) Medicaid covers only residents who meet NF level of care through the OAAS 'pathways' (LAC 50:II.10156). Residents who don't meet it are not covered at all; they are not paid at a reduced rate. The old SN / IC-I / IC-II levels no longer set separate rates. Checked: LAC 50:II.20001-20029 (current Title 50), the M&S 2026 reimbursement training, and the PDPM FAQ.

Verified October 11, 2026

Capital

Fair rental value (LAC 50:II.20005.D.3) in place of depreciation, interest, rent and amortization. Values at 7/1/2026: $329.18 per sq ft, $32.94 per sq ft for land, and $13,506 per licensed bed for movable equipment. These are trended each July 1 by a 2-year moving average of RS Means 3/4-column unit cost (New Orleans city index). Allowed space is 300-450 sq ft per bed; since 1/1/2021, up to 550 if 15%+ of beds are in designated private rooms. Depreciation is 1.25%/yr of weighted age, not on land, with a maximum age of 30 years (so value never falls below 62.5%). Age goes up 1 year each July 1. It can be reduced ('re-age') each quarter for renovations of $500/bed or more placed in service within 24 months, or for bed additions. Rental factor = prior-year average 20-year Treasury + 2.5%, with a 9.25% floor and 10.75% ceiling (9.25% at 7/1/2026). The annual FRV is divided by the greater of actual base-year days or 85% of licensed bed days. Licensed bed changes count only at July 1 of a rebase year unless square footage changes. Non-filers get FRV at 100% occupancy. Fire sprinkler and 2-hour wall costs got a separate 5-year add-on (2007-era; LAC 50:II.20017).

Verified October 11, 2026

Budget adjustment factor

No across-the-board cut found in effect for SFY2027. Standing rule (LAC 50:II.20005.D.6): LDH may create a 'budget reduction category' that lowers every home's rate by an equal amount per patient day. Each $0.30 cut in the average rate lowers the DCCR floor by 1 point, down to 90% of the median. History: per-day cuts of up to $90.26 in 2010-2014 (20005.F-Q, each 'until rebased'), and no inflation in FY2016 and FY2018 (20001.B-C). Upside protection (LR 51:1612, Oct 2025; 20006.B): under La. Const. Art. VII §10.14(E)(1), if the July 1 average Medicaid rate falls below the prior SFY's average (simple average of 4 quarters), LDH adds an equal per-day add-on to every home to close the gap.

Verified October 11, 2026

Add-ons and money outside the rate

Paid outside the posted rate

Level

small

Estimate

Probably under 5% of base, but not confirmed. The only off-rate program with a defined list of homes is the NSGO UPL for 4 small public homes; its dollar size was not found. LINCC could be larger if active, but no payment data was found. There are no MCO directed payments and no lump-sum quality pool. Payments inside the per diem (provider fee pass-through, private room and bed buy-back) are not counted.

Components

NSGO UPL supplemental payments (4 homes, quarterly lump sums; size unknown). LINCC UPL payments to private homes affiliated with a government entity (status and size unknown). Evacuation and sheltering reimbursement (event-driven).

Source

https://www.doa.la.gov/media/ogee2gb4/50.docx

Verified October 11, 2026

Payments by owner type

Applies

yes

Detail

NSGO UPL payments go only to the 4 named non-state government homes (parish or hospital-district units: Gueydan Memorial Guest Home, LaSalle Nursing Home, Natchitoches Parish Hospital LTC Unit, St. Helena Parish Nursing Home). They top up Medicaid to an estimated Medicare (PDPM) payment level. State-owned homes are paid cost-based prospective rates instead of the price. During COVID, public homes were excluded from the $12/day add-on. The size of the gap was not found.

Funding

The non-federal share presumably comes from the public owners through IGTs; the rule does not say, and states that no payment depends on donations. LINCC is the route for private operators: a private home can reach UPL money by signing a 'low income and needy care collaboration agreement' with a state or local government entity.

Source

https://www.doa.la.gov/media/ogee2gb4/50.docx

Verified October 11, 2026

Quality program

Notes

No nursing facility quality or value-based payment was found in LAC 50:II Chapter 200, the M&S 2026 reimbursement training (which lists every rate component and special program), or the LDH rate pages. LDH's 2016-era 'Nursing Home Quality Initiative' (pressure ulcer training with LNHA and LSU) was education only, with no payment. The closest quality-linked lever on money is MDS accuracy: case-mix documentation reviews can lower a home's CMI (see mds_accuracy_penalties).

Verified October 11, 2026

Provider tax

Charged

per occupied bed day (all payers)

Standard amount

$12.08 per occupied bed per day, effective 9/1/2016 (was $10.00); listed as the SFY2026 rate on LDH's MATF page

Lower for high-Medicaid homes

no

Returned in the rate

Flat $12.08 pass-through in every Medicaid per diem (LAC 50:II.20005.D.4.a,c). Leave days pay 10% of the rate excluding the fee, plus the full $12.08.

Source

https://ldh.la.gov/page/matf

Verified October 11, 2026

Provider tax notes

Nursing facility provider fee (Medical Assistance Trust Fund): $12.08 per occupied bed per day, all payers, since 9/1/2016 (was $10.00). Capped at 6% of net patient revenue (42 CFR 433.68) and paid quarterly. A bed counts as 'occupied' whenever any payment is made for it, including bed-hold days and hospice-contract beds. The Medicaid share comes back as a $12.08 pass-through in every Medicaid per diem, and in full on leave days.

Verified October 11, 2026

Supplemental payments

(1) Non-State Governmental Organization (NSGO) UPL payments (LAC 50:II.20029): quarterly lump sums for 4 named public homes: Gueydan Memorial Guest Home, LaSalle Nursing Home, Natchitoches Parish Hospital LTC Unit and St. Helena Parish Nursing Home. Lane Memorial was dropped by the April 2021 amendment. Each payment = estimated Medicare PDPM payments for the home's Medicaid residents minus its Medicaid payments, recalculated each July. The Medicare estimate is adjusted for wage index, urban/rural and SNF VBP, with the NTA component reduced for drugs, lab and x-ray. (2) Low Income and Needy Care Collaboration (LINCC, LAC 50:II.20025, since 11/1/2011): quarterly UPL payments to private or non-state public homes that have a collaboration agreement with a state or local government entity. Each home can get up to its Medicare-minus-Medicaid gap, capped at the available UPL. Current status and size were not found. (3) Evacuation and sheltering cost reimbursement (20019): quarterly lump sums, net of FEMA. There are no MCO directed payments, because nursing home care is fee-for-service.

Verified October 11, 2026

Other add-ons

(1) Provider fee pass-through, $12.08/day. (2) PDPM phase-in pass-through adjustment, 7/1/2025-12/31/2026: whatever amount keeps DCCR within $5 of the RUG-III value. (3) Private room conversion: +$5/day for each Medicaid day in a semi-private room converted to a Medicaid private room after 9/1/2007 (beds surrendered); FRV is restated (LAC 50:II.20010). (4) Bed buy-back incentive (20012): a home that buys and closes another Medicaid NF within 90 days and surrenders its beds gets 5 years of capital incentive payments, paid as a per diem, plus restated FRV and property tax/insurance. Base amounts at 7/1/2026 run from $756,554 to $1,491,052/yr depending on beds surrendered; the buyer gets 67-100% of the base, depending on its occupancy gain. (5) Specialized care add-ons: technology-dependent care (TDC) and neurological rehabilitation (NRTP) per diem add-ons set by LDH (20027). (6) Conditional constitutional hold-harmless add-on (20006.B). (7) Expired: a COVID-19 $12/day add-on for private homes only (Emergency Rules from 4/2020, continued 'for the duration of the PHE'; last seen Feb 2023; presumed to have ended with the federal PHE in May 2023).

Verified October 11, 2026

Units paid separately

(1) Specialized care units (LAC 50:II.20027): skilled nursing technology-dependent care (SN-TDC, e.g. ventilator) and the Neurological Rehabilitation Treatment Program (NRTP, rehabilitation and complex) are paid the home's case-mix rate plus an LDH-set per diem add-on. Since 1/1/2014 their costs and days are inside the case-mix medians and floor. The skilled nursing infectious disease (SN-ID) add-on was folded into case mix on 1/1/2014. Add-on rates are calculated by LDH's CPA contractor and not posted. (2) State-owned or operated NFs (e.g. Villa Feliciana; presumably state veterans homes): cost-based prospective per diem, recalculated each July 1 from the latest cost report (20009.B). Private homes that change ownership to the state get $365.68/day interim, cost-settled to 100% of cost (20024). (3) Geriatric training NF (John J. Hainkel Jr. Home, run under an LSU cooperative endeavor agreement): all-inclusive $365.68/day, no add-ons (20026). (4) New homes (20011): the statewide average CMI for 2 quarters; the statewide average capital rate until age and square footage are documented; statewide average property tax/insurance. After a change of ownership, the prior owner's data is kept. Non-filers get the lowest DC/CR split, no property pass-through, and FRV at 100% occupancy.

Verified October 11, 2026

Payment rules

Managed care for long-term care

Status

no

Detail

Healthy Louisiana MCOs are not responsible for 'institutional long-term care facility/nursing home services' (Mercer rate certification, SFY2023). NF per diems are paid fee-for-service by LDH. No MLTSS program was found.

Verified October 11, 2026

Who pays

fee_for_service. Nursing home services are excluded from the Healthy Louisiana managed care contract, and LDH pays nursing facilities directly. PACE is the only capitated program that covers nursing home care.

Verified October 11, 2026

Managed care rate floor

Not applicable. Nursing home care is carved out of Healthy Louisiana and paid fee-for-service. Source: https://ldh.la.gov/assets/docs/BayouHealth/Rate_Certification…

Verified October 11, 2026

Included in the daily rate

Included: room, board, nursing, routine supplies (IV set-ups, tubing, gauze, dressings), incontinence supplies, intermittent catheter supplies, laundry, temporary or emergency oxygen, and a statewide DME price. Paid separately: (a) prescription drugs, through the Medicaid pharmacy program (also indwelling catheters and trays); (b) long-term oxygen concentrators, through the DME program with prior authorization; (c) colostomy supplies, with prior authorization; (d) ventilator equipment for dual eligibles after day 20; (e) physician, hospital, lab and x-ray, billed by those providers (the UPL rule treats pharmacy, lab and radiology as outside the Medicaid per diem). Hospice residents: Medicaid pays the hospice an amount equal to the NF per diem for room and board. How therapy is handled for Medicaid long-stay residents was not confirmed. Source: LAC 50:II.10123 (vendor payment and covered supplies), 20029.

Verified October 11, 2026

Bed hold

Hospital stays

Paid, up to 7 days per hospital stay, at 10% of the per diem excluding the provider fee, plus the full $12.08 fee (training example: $41.89/day on a $310.18 rate).

Leave days

Home leave: up to 15 days per year, at the same 10% of rate plus provider fee.

Occupancy rule

None now. From 2009 to 2013, leave pay depended on 90% occupancy (90% of the rate at or above 90% occupancy, 10% + fee below). Since 7/1/2013 it is a flat 10% + fee.

Notes

Homes may bill the resident for bed holds beyond the Medicaid limits, at no more than the Medicaid rate (LAC 50:II.10123). Bed-hold days count as occupied for the provider fee.

Source

https://myersandstauffer.com/documents/LA/NF/CaseMix/Provider…

Verified October 11, 2026

Personal needs allowance

Per month

45

Effective

2025-07-01

Notes

LDH Medicaid Eligibility Manual Z-700 (reissued Jan. 7, 2026): LTC Personal Care Needs Allowance $45 effective July 1, 2025 for both non-MAGI and MAGI residents (before June 30, 2025: $38 non-MAGI, $30 MAGI). Also: VA improved pension reduction $90; LTC optional state supplement up to $15 (was up to $8). R.S. 40:2009.45 (Acts 2025, No. 259, eff. June 11, 2025) tells LDH to set at least $50 ($100 per couple), but the increase depends on a specific appropriation and Z-700 still shows $45. Not COLA-indexed.

Confidence

confirmed

Source

https://ldh.la.gov/assets/medicaid/MedicaidEligibilityPolicy/…

Verified October 11, 2026

Medicare coinsurance days

Method

lesser_of

Rule

State plan Supplement 1 to Attachment 4.19-B ('Payment of Medicare Part A and Part B Deductible/Coinsurance', page 2) marks Part A deductibles and coinsurance 'SP' for QMBs, other Medicaid recipients and dual eligibles (QMB Plus): 'Payments are limited to State plan rates and payment methodologies.' Payment up to the full Medicare amount ('MR') is listed only for Title XVIII-only services, inpatient and skilled nursing units in small rural hospitals, hospice and (Part B) prescription drugs; freestanding nursing facilities are not on that list. LAC 50:I.8303.A.2 likewise limits Part A and B coinsurance and deductibles 'to the total Medicaid allowable cost for each covered service', and LDH's crossover billing notice describes a 'cost comparison methodology' that compares the Medicaid allowable to Medicare's payment, pays $0 when Medicare's payment is higher, and never pays more than the coinsurance. Medicaid starts paying coinsurance on day 21 (LAC 50:II.10123). No nursing-facility rule for Medicare Advantage cost sharing was found.

Effect

Medicare's day 21-100 SNF payment is usually well above the home's Medicaid rate (about $300), so LDH usually pays $0 or only part of the daily coinsurance; homes in small rural hospital SNF units are the exception and get the full coinsurance.

Confidence

confirmed

Source

https://ldh.la.gov/assets/medicaid/StatePlan/Sec4/Attachment4… ; https://www.doa.la.gov/media/ogee2gb4/50.docx ; https://www.lamedicaid.com/provweb1/billing_information/Cross…

Verified October 11, 2026

Required care spending

Applies

yes

Rule

DCCR spending floor (LAC 50:II.20005.D.1.e,h). Each home's audited direct care + care-related cost per day is compared with the day-weighted average of its quarterly CMI-adjusted floors for the cost report year. A home spending below the floor refunds the shortfall x its Medicaid days. The floor is 94% of the statewide median: 90% during the PDPM phase-in (7/1/2025-12/31/2026), back to 94% on 1/1/2027. It drops 1 point for each $0.30 budget cut, down to 90%. Refunds are calculated yearly after audit or desk review (Schedule J of the Medicaid supplemental report). Exemption: a state home converted to private operation through a Region 1 lease is exempt for 12 months (20023). Training example: $3.16/day x 29,429 Medicaid days = $92,996 owed.

Source

https://myersandstauffer.com/documents/LA/NF/CaseMix/Provider…

Verified October 11, 2026

Occupancy rules

Applies

yes

Rule

Capital (FRV) per day = annual FRV / the greater of actual base-year resident days or 85% of licensed bed days. Bed changes use the greater of actual occupancy or 85%. Non-filers are set at 100% occupancy. There is no occupancy test for DCCR, A&O, property tax and insurance (actual days), or leave days (the 90% occupancy tier was repealed 7/1/2013).

Source

https://www.doa.la.gov/media/ogee2gb4/50.docx

Verified October 11, 2026

MDS accuracy penalties

Case-Mix Documentation Reviews (LAC 50:II.20013), done by M&S for LDH. The sample is the greater of 20% of occupied beds or 10 assessments from the latest final CMI report, and it is expanded if more than 20% are unsupported. If more than 20% of the total sample is unsupported (the threshold since 1/1/2006), the affected PDPM components are reclassified and the home's CMI and Medicaid rate are recalculated for that quarter (recoupment). A follow-up review may follow a 90-day correction period, and a documentation improvement plan (DIP) may be required. From 10/1/2026, homes with 2 consecutive reviews over 20% unsupported must file their own DIP within 30 days (M&S memo 9/1/2026). Delinquent MDS assessments get the lowest CMI. Separately, the DCCR floor refund (see spending_requirements) is a penalty on the cost side.

Verified October 11, 2026

Published rates and changes

How often rates change

A home's rate changes

quarterly

When

Jan 1, Apr 1, Jul 1 and Oct 1. Each quarter updates the CMI (from the quarter ending 3 months earlier), FRV re-ages, private room conversions and the PDPM corridor adjustment. July 1 also brings price inflation or a rebase (at least every 2 years; last 7/1/2025), the FRV aging year, the rental factor and RS Means values.

Verified October 11, 2026

When rates change

July 1 state fiscal year, with quarterly case-mix rates (1/1, 4/1, 7/1, 10/1). Rebase 7/1/2025. The PDPM phase-in ends 12/31/2026, and the floor returns to 94% on 1/1/2027.

Verified October 11, 2026

Posted rates

Home-level rates published

No

Where

No public per-facility rate file was found on LDH's Rate Setting and Audit page (https://ldh.la.gov/medicaid/rate-setting-and-audit-section), the lamedicaid.com fee schedules, or Myers and Stauffer's public Louisiana page. Rate sheets and CMI reports go to each provider through the M&S Louisiana case-mix web portal (lacasemixreports.mslc.com), which requires a login.

Format

none (public); provider-specific rate sheets via portal

Cadence

Quarterly, to providers

History

None public. One-time shadow PDPM rate sheets (Jan 2025) went to providers only.

Home identifier

Medicaid provider number (7-digit, e.g. 0054321 on M&S CMI reports)

Verified October 11, 2026

Rate build-ups

Published

No

Where

Not public. M&S gives each provider a 'Rate Sheet' showing how its rate is built. The 2026 training slides show sample rate sheets and worked examples.

What they show

Per the training: A&O price; DCCR price split into direct care (x quarterly CMI) and care-related; DCCR floor; FRV inputs and per diem; property tax and insurance; provider fee; PDPM phase-in adjustment; leave-of-absence rate.

Format

pdf (provider portal)

Example file

https://myersandstauffer.com/documents/LA/NF/CaseMix/Provider…

Verified October 11, 2026

Recent changes

Verified October 11, 2026

Assisted living

Medicaid assisted living

Covered

no

Program

None. Louisiana Medicaid does not pay for assisted living (adult residential care). The Community Choices 1915(c) waiver covers in-home services (personal assistance, adult day health care, home-delivered meals, nursing, monitored in-home caregiving, etc.), not an assisted living service. Its only link to assisted living is caregiver temporary support (respite), which can include an overnight stay in a licensed assisted living facility (LAC 50:XXI.8313). Adult Residential Care facilities are licensed under LAC 48 and paid privately.

What is paid

Nothing for ongoing assisted living residence; respite stays only (at most 30 days or 29 overnight stays per plan year).

Rate

No Medicaid ALF rate.

Limits

n/a (CCW itself has a Request for Services Registry / waitlist)

Source

https://www.doa.la.gov/media/ogee2gb4/50.docx

Verified October 11, 2026

Sources

1. Louisiana Administrative Code Title 50 (current, Office of the State Register): Part II Ch. 101 and Ch. 200 (LAC 50:II.20001-20029), Part I §8303, Part XXI Community Choices Waiver · regulation
2. Myers and Stauffer, LA 2026 NF Reimbursement Training slides (8/27/2026) · agency page
3. FAQ Louisiana NF PDPM Transition v1.1 (5/13/2025) · agency page
4. LDH memo: PDPM transition effective 7/1/2025 (1/13/2025) · agency page
5. LDH cover letter: shadow PDPM rates and +/-$5 corridor · agency page
6. Louisiana Register Vol. 51 No. 7 (July 2025): NF Reimbursement Methodology Emergency Rule, Notice of Intent and fiscal note · regulation
7. Louisiana Register Vol. 51 No. 10 (Oct 2025): NF Reimbursement Methodology final Rule (LR 51:1610-1613) · regulation
8. Louisiana Register Vol. 49 No. 2 (Feb 2023): COVID-19 Emergency Rule continuing the $12 NF add-on · regulation
9. Office of the State Register archives (2023-2025 Register editions, incl. Oct 2023 / Feb 2024 OSA rules) · regulation
10. LDH Medical Assistance Trust Fund (MATF) Provider Fees page · agency page
11. LDH Rate Setting and Audit Section page · agency page
12. Myers and Stauffer Louisiana case-mix provider resources · agency page
13. M&S memo: Documentation Improvement Plans effective 10/1/2026 (9/1/2026) · agency page
14. LDH Nursing Home Cost Report Filing memo (CMS-2540-24), 10/16/2025 · agency page
15. Mercer, Healthy Louisiana Rate Certification SFY2023 (excluded services) · agency page
16. LAC 50 Subparts 3 and 5 as of May 2020 (LDH-hosted, for history) · regulation
17. Louisiana Medicaid State Plan, Supplement 1 to Attachment 4.19-B (Payment of Medicare Part A and Part B Deductible/Coinsurance) · state plan
18. LDH/Medicaid crossover billing notice: cost comparison methodology (2018) · agency page
19. Personal needs allowance · secondary

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