Common use of Nursing Facility Cost Ceiling Clause in Contracts

Nursing Facility Cost Ceiling. The annualized cost of serving an Enrollee in a Nursing Facility. A per diem cost is established for each Medicaid Nursing Facility resident based on the level of care needed. This level of care and associated resource allocation is referred to as the Resource Utilization Group (RUG) level. The per diem cost is annualized to achieve the Nursing Facility ceiling.