SB 212

Federal and state requirements for nursing homes

Under current law, a nursing home that receives Medicaid or Medicare funding

for the care of a resident is subject to both federal and state requirements. The

Department of Health Services (DHS) enforces both federal and state requirements

for nursing homes. Currently, for nursing homes that are Medicaid and Medicare

providers, DHS may issue both federal and state citations for the same practice and

may recommend federal remedies and impose state sanctions. This bill prohibits

DHS from issuing a notice of violation of a state requirement to a nursing home that

is a Medical Assistance or Medicare provider if DHS has, in a statement of deficiency,

cited the nursing home for a violation of a federal requirement that is based on the

same facts.

Under current law, DHS may seek an injunction in court to enjoin the repeated

violation of the state's nursing home statutes or a rule promulgated under the

authority of the state's nursing home statutes. The bill allows DHS to seek an

injunction to enjoin repeated violation of certain federal requirements related to the

operation of a nursing home.

Monetary penalties

Under current law, DHS may assess a forfeiture against a nursing home for a

violation of a state requirement. There is no time limit for DHS to assess a forfeiture

for a violation. Nursing homes must pay forfeitures to DHS within ten days after

receipt of notice of imposition of the forfeiture or after receipt of the final decision

after exhaustion of administrative review. If a nursing home does not contest a notice

of violation and a forfeiture and pays the forfeiture within ten days after receipt of

the notice, DHS must reduce the forfeiture amount by 35 percent.

The bill requires DHS to impose a forfeiture within 120 days of notifying a

nursing home of a violation or DHS loses the authority to impose a forfeiture. The

bill changes to 60 days the time period by which a nursing home must pay forfeitures

to DHS after receipt of the notice of imposition or the final decision after exhaustion

of administrative review, and also changes to 60 days the time period within which

a nursing home may pay a forfeiture and have the forfeiture amounts reduced by 35

percent.

Appeals

Currently, in order to appeal a DHS finding that the nursing home violated a

state requirement, a nursing home must request a hearing on the finding within ten

days of receiving notice of the violation. If DHS assesses a forfeiture for the violation

and the nursing home wishes to appeal the forfeiture, the nursing home must request

a separate hearing on the forfeiture within ten days of receiving notice of a contested

action. Upon request of the nursing home, the hearing on the finding of violation may

be stayed until DHS assesses a forfeiture so that the hearing on the finding of

violation and the hearing on the forfeiture may be consolidated.