SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
Effective Date of Rule: July 1, 2011.
Purpose: Chapter 7, Laws of 2011 1st sp. sess. (the act) imposes a safety net assessment (SNA) on nonexempt nursing facilities in Washington state.
Citation of Existing Rules Affected by this Order: Amending [new section] WAC 388-96-910.
Statutory Authority for Adoption: Chapter 74.46 RCW.
Other Authority: Chapter 7, Laws of 2011 1st sp. sess.
Under RCW 34.05.350 the agency for good cause finds that in order to implement the requirements or reductions in appropriations enacted in any budget for fiscal years 2009, 2010, or 2011, which necessitates the need for the immediate adoption, amendment, or repeal of a rule, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the fiscal needs or requirements of the agency.
Reasons for this Finding: Effective July 1, 2011, the department will implement the new safety net assessment on Washington nursing facilities. Emergency rules are necessary in order to provide additional direction for implementation of this new regulation.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 1, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 0.
Date Adopted: June 30, 2011.
Katherine I. Vasquez
(2) The status of each nursing facility under the Act will be determined based on the facility's characteristics as of July 1, 2011, but using the information on resident days from the 2010 cost report. The status of facilities will not be altered thereafter during SFY 2012.
(3) The office of rates management (ORM) of the aging and disability services administration (ADSA) of the department of social and health services (the department) will inform each nursing facility of its status under the Act. A facility wishing to contest its status under the Act as determined by ORM may seek review of such determination under WAC 388-96-904.
(4) Beginning July 1, 2011, an add-on to each nonexempt facility's medicaid daily rate will be paid to reimburse the facility for the SNA it owes in relation to residents whose care is provided by medicaid.
(5) The SNA is assessed and payable on a monthly basis. The SNA owed for each month must be received by the 25th day of the following month. The SNA will be reported on a form supplied by ORM. Payments of the SNA are subject to an interest penalty of one percent per month for any payment which is delinquent for any portion of a month. The department may withhold any medical assistance reimbursement payments from a facility until such time as any delinquent SNA payments, and any related penalties, are paid, or may offset such delinquent SNA payments and related penalties against the facility's medical assistance reimbursement payments.
(6) Enforcement and collection of the SNA provided by the Act is subject to successful application for a related waiver from the federal centers for medicare and medicaid services (CMS). In the review process for the waiver, it may be necessary for DSHS to modify the levels of the SNA, the standard for designating facilities that pay the SNA at the lower level, and/or the categories of fully exempt facilities described in section 17 of the Act. In that case, the obligation of each facility to pay the SNA is subject to amendment retroactive to July 1, 2011, based on the standards for the SNA contained in the waiver as eventually issued by CMS.