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hello everybody and welcome to our discussion of change request 13413 also known as transmittal 12747 and this change of request deals with the SSI realignments prior to 10123 so for the agenda for this discussion weamp;#39;re going to be talking about an overview of the SSI realignments and then weamp;#39;ll talk about an overview of the actual change request and finally weamp;#39;ll wrap up with a process for requesting these realignments so first of all letamp;#39;s take a look at the overview of SSI realignments in general what does that term mean what are these so if we take a look at the Dish payment we have what is known as the operating Dish payment on worksheet e part A of the cost report and the capital dish which is on worksheet L now the Dish payment is based on the sum of two different ratios or proxies known as the SSI ratio and the Medicaid ratio the SSI ratio is something weamp;#39;ve always received from CMS thatamp;#39;s where providers get the ratio from to plu
