to establish provisions allowing a Medicaid certified nursing facility to protect its facility need review approvals for a period of time due to a declared disaster or other emergency situation.
This action is being taken to promote the health and well-being of Louisiana citizens by assuring the availability of nursing facility services in areas that have been affected by a declared disaster or other emergency situation through the protection of the facility need review bed approvals of the impacted facilities for a specified time period. It is estimated that implementation of this Emergency Rule will have no programmatic costs for state fiscal year 2008-2009.
Effective October 11, 2008, the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing amends the provisions governing facility need review for Medicaid certified nursing facilities in Louisiana.
Part I. General Administration
Subpart 5. Health Planning
Chapter 125.Facility Need Review
A. - F.4.…
5.Except as provided in Subsection G and Subsection I, approvals shall be revoked when a facility’s license is revoked, or not renewed, or denied, unless the facility obtains a license within 120 days from the date of such revocation, non-renewal, or denial.
6.Except as provided in Subsection G and Subsection I, approvals shall be revoked when a facility’s provider agreement is terminated unless, within 120 days thereof, the facility enters into a new provider agreement.
7.Except as provided in Subsection G and Subsection I, beds may not be disenrolled, except as provided under the alternate use policy, the bed approval exception for declared disasters and other emergency situations, and during the 120 day period to have beds re-licensed or re-certified. The approval for beds disenrolled, except as indicated, will automatically expire.
F.8 - H.2.…
I.Exception Criteria for Bed Approvals of Nursing Facilities Affected by Disasters or Other Emergencies.
1.The facility need review bed approvals for a licensed and Medicaid certified nursing facility located in an area or areas which have been affected by an executive order or proclamation of emergency or disaster issued in accordance with R.S. 29:724 or R.S. 29:766 shall remain in effect and shall not be terminated, revoked or considered to have expired for a period not to exceed two years following the date of such executive order or proclamation, provided that the following conditions are met:
a.The nursing facility shall submit written notification to the Health Standards Section within 60 days of the date of the executive order or proclamation of emergency or disaster that:
i.the nursing facility has experienced an interruption in the provisions of services as a result of events that are the subject of such executive order or proclamation of emergency or disaster issued in accordance with R.S. 29:724 or R.S. 29:766;
ii.the nursing facility intends to resume operation as a nursing home in the same service area; and
iii.includes an attestation that the emergency or disaster is the sole causal factor in the interruption of the provision of services;
NOTE:Pursuant to this Emergency Rule, an extension of the 60 day deadline may be granted at the discretion of the department.
b.The nursing facility resumes operating as a nursing home in the same service area within two years of the executive order or proclamation of emergency or disaster in accordance with R.S. 29:724 or R.S. 29:766; and
c.The nursing facility continues to submit required documentation and information to the Department.
2.The provisions of this section shall not apply to:
a. a nursing facility which has voluntarily surrendered its facility need review bed approval; or
b.a nursing facility which fails to resume operations as a nursing facility in the same service area within two years of the executive order or proclamation of emergency or disaster in accordance with R.S. 29:724 or R.S. 29:766.
3.Failure to comply with any of the provisions of this subsection shall be deemed a voluntary surrender of the facility need review bed approvals.
AUTHORITY NOTE:Promulgated in accordance with R.S. 40:2116.
HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 21:806 (August 1995), amended LR 25:1250 (July 1999), LR 28:2190 (October 2002, LR 30:1023 (May 2004), LR 32:845 (May 2006), LR 35:
Interested persons may submit written comments to Jerry Phillips, Bureau of Health Services Financing, P.O. Box 91030, Baton Rouge, LA 70821-9030. He is responsible for responding to inquiries regarding this Emergency Rule. A copy of this Emergency Rule is available for review by interested parties at parish Medicaid offices.
DECLARATION OF EMERGENCY
Department of Health and Hospitals
Office of the Secretary
Bureau of Health Services Financing
Inpatient Hospital Services Small Rural Hospitals Reimbursement Methodology (LAC 50:V.1125 and 1127)
The Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing adopts LAC 50:V.1125 and 1127 in the Medical Assistance Program as authorized by R.S. 36:254 and pursuant to Title XIX of the Social Security Act. This Emergency Rule is promulgated in accordance with the provisions of the Administrative Procedure Act, R.S. 49:953.B(1) et seq., and shall be in effect for the maximum period allowed under the Act or until adoption of the final Rule, whichever occurs first.
The Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing adopted a Rule which established the prospective reimbursement
Louisiana Register Vol. 34, No. 10 October 20, 2008