Attention MaineCare Section 67, Nursing Facilities (NFs): Additional Extraordinary Circumstance Allowance (ECA) Payments

Sep 06, 2024

As authorized by P.L. 2023 Ch. 643 Part UU and Part SSS, the Department has distributed a supplemental payment to NFs on September 5, 2024.

The aftermath of the pandemic produced an unforeseeable and uncontrollable increase in the cost of living, for both fixed costs and labor costs, as well as a workforce shortage. Higher costs are still causing extraordinary strain on NFs ability to serve our most vulnerable population, and this payment is intended to support facilities' continued operations. The Department is working to implement NF rate reform. For updates on all MaineCare rate determination efforts please see the Rate System Reform webpage.

Payment methodology

These payments have been distributed proportionally between NFs based on two criteria:

1) the actual total allowable MaineCare costs, and

2) total direct care hours not including contract labor.

The data informing the allocation methodology is from each facility’s 2023 cost report filing. A total of $30 million was available for this payment and was pro-rated across providers. These payments are intended to be for prospective and retroactive costs and will be cost settled. These payments are for direct care and other MaineCare allowable costs, including capital costs. Eligible facilities must be in operation and serving residents as of September 1, 2024. Facilities planning to close this calendar year are not eligible for receipt of payment.

Period of Allowable Use:

Providers can apply their supplemental payment to allowable expenses incurred from the beginning of their cost report periods for fiscal years ending between December 31, 2023, and September 30, 2024, through to a universal end date of December 31, 2024.

For example:

• A provider with a September 30 fiscal year end can claim expenses for the period from October 1, 2023, through December 31, 2024.
• A provider with a March 31 fiscal year end can claim expenses for the period from April 1, 2023, through December 31, 2024.

Cost Settlement

The supplemental payment will be reconciled separately, and at the same time as the provider’s annual cost report audit. Providers need to submit a financial reconciliation to the DHHS-Division of Audit with their cost report filings for fiscal years ending in 2024. The reconciliation will be included in the cost report templates posted on the Division of Audit’s website. Providers with a December 31, 2023, fiscal year end, who plan on using all or part of these funds toward expenses claimed on the December 31, 2023, cost report, must complete the Schedule GG and submit it to the Division of Audit by November 15, 2024.

If you have any questions regarding cost settlement or the Schedule GG, please contact Trisha White with the Division of Audit, and include “NF Supplemental Payment” in the subject line or call the Division of Audit at (207) 287-2403.

Identification of payment

For NFs receiving these funds, the invoice type should display on any paper Remittance Advice (RA) listed as “OTHER.” For NFs with electronic invoices the number should display with a prefix of “ECA” for these payments. 

Please contact your Provider Relations Specialist, Bruce Cosgrove, with questions.