The purpose and effect of the proposed rule development is to incorporate changes to the Florida Title XIX Long-Term Care Reimbursement Plan payment methodology, effective July 1, 2007. 1. The operating and indirect patient care component targets and target rate class ceilings of the Medicaid nursing home per diem rate shall be rebased. The operating and indirect patient care components of the per diem rate shall continue to be limited by the lower of the cost-based class ceiling, the target rate class ceiling, or the individual provider-specific target. 2. Establish a target rate class ceiling floor equal to 90 percent of the cost-based class ceiling. 3. Establish an individual provider-specific target floor equal to 75 percent of the cost-based class ceiling. 4. Modify the inflation multiplier to equal 2.0 times inflation for the individual provider-specific target. (The inflation multiplier for the target rate class ceiling shall remain at 1.4 times inflation.) 5. Modify the calculation of the change of ownership target to equal the previous providers’ operating and indirect patient care cost per diem (excluding incentives), plus 50 percent of the difference between the previous providers’ per diem (excluding incentives) and the effective class ceiling and use an inflation multiplier of 2.0 times inflation. 6. The methodology for nursing home special Medicaid payments is being revised. 7. The low occupancy adjustment is being removed.