No. 37177 (5-year Review): Rule R414-27. Medicaid Certification of Nursing Care Facilities

DAR File No.: 37177
Filed: 01/09/2013 01:12:15 PM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

Section 26-18-503 authorizes the Department to certify nursing facility programs to provide cost effective services to Medicaid recipients. In addition, Section 26-18-3 requires the Department to implement by rule standards to administer nursing facilities within the Medicaid program.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

The Department received written comments on this rule after it filed a proposed change that defined third party ownership. The comments suggested the definition was too broad in making third party owners assume Medicaid liabilities of a previous nursing facility program in the case of a sale or transfer of a facility, and would discourage lessors, lenders, and management companies from making purchases of distressed nursing facilities. Another comment on this change suggested removing a provision that wrongfully limited the mile radius necessary for a nursing facility operating in a new or renovated facility to be eligible for recertification. A final comment on this change suggested the rule include an exception (in accordance with Section 26-18-505 to the provision that requires nursing facilities to always receive approval from the Medicaid Director for the transfer of Medicaid-certified beds to other nursing facilities or to build new nursing facilities within the same or different counties.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

The Department filed a change to the proposed rule to address the written comments. The Department will continue this rule because it provides cost effective services to nursing facility residents and governs the certification of nursing care facilities to receive Medicaid payments for services to Medicaid eligible individuals.

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

Health
Health Care Financing, Coverage and Reimbursement Policy
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at [e-mail]

Authorized by:

David Patton, Executive Director

Effective:

01/09/2013

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