Pursuant to V.P.N.M.I.R. §1.8(d), the PNMI Practices and Procedures Manual contains interpretations of the PNMI Rules and other materials describing the manner in which those rules are carried out. The Manual also contain forms prescribed by the Division. The Practices and Procedures Manual is compiled and maintained pursuant to 3 V.S.A. §8.35
Table of Contents
96-1 Representation of a PMNI Facility
To enable the Division to identify the official representative of the provider and to know where communications should be sent, a written notification must be filed by the provider, pursuant to V.P.N.M.I.R. §1.11(b).
The Division's rules contain a number of time limits for providers. Because it is not always possible to meet these deadlines, the rules also contain provisions to permit the extension of time limits, at V.P.N.M.I.R. § 3.3(c).
Request for Extension of Time - Form Fill
Request for Extension of Time Form
This form should be used for all requests for an extension of time, including extensions of time to file Funding Applications, pursuant to V.P.N.M.I.R. § 3.3(c)(1)
Pursuant to 3 V.S.A. §317(b)(6) and V.P.N.M.I.R. §2.5(f) providers' financial records filed with the Division are public records and are available for inspection or copying.
96-4 Procedures for Administrative Review of Funding Application Findings
This issuance describes the steps necessary to appeal actions of the Division taken after review or audit of providers' funding applications, pursuant to V.P.N.M.I.R. §§12.1-12.3. Each step of this review procedure must be completed before further review is available. No appeal of funding application findings may be taken pursuant to V.P.N.M.I.R. §12.4, unless the Division's administrative review procedures have first been exhausted.
96-5 Form - Request for Work Papers
This form should be used whenever the provider needs to have access to the Division's work papers in order to review the calculations. Normally this form will be used to help the provider review the draft findings pursuant to V.P.N.M.I.R. §12.1(b) and for that purpose the form must be filed at the Division within 10 days after the provider receives the draft findings. The filing of a Request for Work Papers pursuant to V.P.N.M.I.R. §12.1(b) will automatically extend the time in which to file a Request for Informal Conference to 15 days after the provider's receipt of the work papers.
96-6 Form - Request for Informal Conference
This form should be used to initiate all administrative reviews of the Division's cost report findings. (V.P.N.M.I.R. §12.2) If a timely Request for Informal Conference is not filed, the provider is not entitled to any further administrative or judicial review of the cost report findings for the period in question.
96-7 Form - Notice of Request for Reconsideration
This form which consists of a cover sheet with a number of schedules should be used to initiate a formal administrative review of the Division’s findings (official action) issued after an informal conference. The form, along with the relevant supporting schedules, must be filed within 30 days of the provider’s receipt of the Official Action. If no timely Notice of Request for Reconsideration is filed, the provider is not entitled to further administrative review of the Official Action for the period in question. (V.P.N.M.I.R. §12.3)
10-1 Monthly Report of Vermont PNMI Resident Days
Instructions for completing the Monthly Report of Vermont PNMI Resident Days Report.
10-1 Form - Monthly Report of Vermont PNMI Resident Days (MS Excel)
Form used to submit PNMI resident days each month. This Excel file may be downloaded, filled out and emailed to the Division of Rate Setting.
The Division of Rate Setting (Division) is charged with issuing guidelines for utilization percentages to be used in calculating PNMI providers’ per diem rates per V.P.N.M.I.R. §6.6. This practice and procedure issuance details how the Division will use the base year utilization percentages, subject to the minimum occupancy percentages applicable to each program, to set PNMI per diem rates. This Practice and Procedure issuance replaces all prior utilization and minimum occupancy requirement issued by the Placement Authorizing Departments (PADs).
14-2 Materiality Test for PNMI Rate Adjustments
The Division of Rate Setting (Division) is charged with issuing guidelines for materiality for purposes of PNMI providers applying for rate adjustments pursuant to V.P.N.M.I.R. §8. Providers cannot request an adjustment to their final rates unless the proposed adjustment is material. Materiality varies based on the annual total allowable costs of the program.
14-3 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2015
This Practices and Procedures Issuance announces the rebase of costs for Private Non-Medical Institutions (PNMI) used for the setting of Medicaid rates for services provided during State Fiscal Year 2015, which begins on July 1, 2014.
14-4 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2016
This Practices and Procedures Issuance announces the rebase of costs for Private Non-Medical Institutions (PNMI) used for the setting of Medicaid rates for services provided during State Fiscal Year 2016, which begins on July 1, 2015.
14-5 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2017
16-1 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2018
16-2 Application for a Rate Adjustment
16-2F Application for Rate Adjustment (FORM)
17-1 Funding Application - Completion and Submission of Form
17-1F Funding Application (Form)
17-2 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2019
19-1 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2020
19-2 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2021
20-1 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2022
21-1 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2023
22-1 Rebasing of Private Non-Medical Institutions for State Fiscal Year 2024
23-7 Form - Request for Extraordinary Financial Relief (EFR)