No. 39514 (Amendment): Section R432-3-10. Alternative Remedies for Nursing Facilities

(Amendment)

DAR File No.: 39514
Filed: 07/15/2015 10:05:08 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The implementation of this rule is part of the responsibility of the Bureau of Health Facility Licensing and Certification; however this section has been housed within Medicaid. This action adds Section R432-3-10 for oversight and maintenance by the Bureau of Health Facility Licensing and Certification. The purpose of this change is to update and clarify alternative remedies for nursing facilities but will not change the current process.

Summary of the rule or change:

This new rule section updates and clarifies alternative remedies for nursing facilities. This new rule section also makes other technical corrections to the old rule.

State statutory or constitutional authorization for this rule:

• Title 26, Chapter 21

Anticipated cost or savings to:

the state budget:

There is no impact to the state budget because the changes in this rule only clarify alternative remedies for nursing facilities but will not change the current process.

local governments:

There is no impact to local governments because the changes in this rule only clarify alternative remedies for nursing facilities but will not change the current process.

small businesses:

There is no impact to small businesses because the changes in this rule only because the changes in this rule only clarify alternative remedies for nursing facilities but will not change the current process.

persons other than small businesses, businesses, or local governmental entities:

There is no impact to businesses, individuals, local governments, and persons that are not small businesses because the changes in this rule only clarify alternative remedies for nursing facilities but will not change the current process.

Compliance costs for affected persons:

There is no impact to single persons because the changes in this rule only clarify alternative remedies for nursing facilities but will not change the current process.

Comments by the department head on the fiscal impact the rule may have on businesses:

There is no fiscal impact because this rule does not add any requirements to the already existing requirements in rule.

David Patton, PhD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Family Health and Preparedness, Licensing
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106

Direct questions regarding this rule to:

• Joel Hoffman at the above address, by phone at 801-273-2804, by FAX at 801-274-0658, or by Internet E-mail at [e-mail]
• Carmen Richins at the above address, by phone at 801-273-2802, by FAX at 801-274-0658, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

08/31/2015

This rule may become effective on:

09/07/2015

Authorized by:

David Patton, Executive Director

RULE TEXT

R432. Health, Family Health and Preparedness, Licensing.

R432-3. General Health Care Facility Rules Inspection and Enforcement.

R432-3-10. Alternative Remedies for Nursing Facilities.

(1) The department conducts on-site inspections of nursing facilities to determine compliance with state and federal nursing home requirements. When the department finds that a nursing facility is out of compliance with requirements of participation, the department may apply remedies, including Federal civil money penalties (CMP) to compel the facility to implement corrective measures to achieve compliance.

(2) For Medicare and/or Medicaid certified nursing facilities the authority to apply the remedies described in this section is defined in the federal Omnibus Budget Reconciliation Act (OBRA) of 1987 (P.L. 100-203), which mandates compliance with requirements for participation in the program, and in Section 26-18-3 of the Utah Code Annotated 1953. Section 1819(h) and 1919(h) of the Social Security Act specifies remedies available to a state when a skilled nursing facility (SNF) or nursing facility (NF) is out of compliance with the participation requirements. This section requires the state to ensure prompt compliance, and it further specifies that the available remedies are in addition to other remedies available under state or federal law and, except for Federal CMP, are imposed prior to the conduct of a hearing.

(3) This rule establishes criteria for the imposition of remedies authorized by statute.

(4) The department adopts and incorporates by reference the regulations in 42 CFR, Part 488-Survey, Certification, and Enforcement Procedures, as amended in the Federal Register for November 10, 1994, 59 FR 56237. Remedies available for non-compliance with one or more participation requirements may include:

(a) temporary management;

(b) denial of payment for new admissions;

(c) transfer of residents;

(d) closure of the facility and transfer of residents;

(e) state monitoring; and

(f) Civil Money Penalties. Civil Money Penalties may be imposed for either:

(i) the number of days a facility is out of compliance with one or more participation requirements; or

(ii) for each instance that a facility is not in substantial compliance.

(5) Interest shall be assessed on the unpaid balance of the Federal CMP, beginning on the due date. The interest rate charged shall be the average of the bond equivalent of the weekly 90-day U.S. Treasury bill auction rates during the period for which interest will be charged.

(6) Disposition of Federal CMP Collected.

(a) The department shall deposit Federal CMP and corresponding interest collected from Medicaid certified facilities in the General Fund in accordance with Section 26-18-3(5).

(b) Federal CMP collected by the department must be applied in accordance with Section 1819 and 1919 of the act for the protection of the health and property of residents.

 

KEY: health care facilities

Date of Enactment or Last Substantive Amendment: [February 27, 2014]2015

Notice of Continuation: August 12, 2013

Authorizing, and Implemented or Interpreted Law: 26-21-5; 26-21-14 through 26-21-16

 

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